Pennsylvania safety-net hospitals Archives - Page 5 of 22 - Safety-Net Association of Pennsylvania

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.”

jsteinbock2021-07-07T20:30:43+00:00July 8th, 2021|Coronavirus, COVID-19, Pennsylvania safety-net hospitals|Comments Off

Change Atop PA’s Department of Human Services

Teresa Miller is out and Meg Snead will be in as Pennsylvania’s new Secretary of the Department of Human Services.

In separate news releases the Wolf administration announced that Miller, who has led DHS since 2015, “will be moving on to a new opportunity outside Pennsylvania” and leave her job at the end of April and that she will be replaced by Meg Snead, who currently serves as the governor’s Secretary of Policy and Planning.

Snead’s nomination is subject to confirmation by the state Senate.

The Secretary of the Department of Human Services is important to SNAP members and Pennsylvania safety-net hospitals because the state’s Medicaid program is administered by that department’s Office of Medical Assistance Programs.

Learn more about Miller’s departure here and about Snead’s nomination here.

PA Safety Net Admin2021-03-25T06:00:37+00:00March 25th, 2021|Pennsylvania Medicaid, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met for two days last week in Washington, D.C.

The following is MACPAC’s own summary of the sessions.

MACPAC kicked off its January meeting with a review of a draft chapter for the March 2021 report to Congress and recommendations on a mandatory extension of Medicaid coverage for 12 months postpartum. The Commission received extensive public comment on the recommendations. On Friday, the Commission approved three recommendations as drafted related to postpartum coverage. The Commission recommended that Congress should:

extend the postpartum coverage period for individuals who were eligible and enrolled in Medicaid while pregnant to a full year of coverage, regardless of changes in income. Services provided to individuals during the extended postpartum coverage period will receive an enhanced 100 percent federal matching rate;
extend the postpartum coverage period for individuals who were eligible and enrolled in the State Children’s Health Insurance Program (CHIP) while pregnant (if the state provides such coverage) to a full year of coverage, regardless of changes in income; and
require states to provide full Medicaid benefits to individuals enrolled in all pregnancy-related pathways.

Commissioners then turned their attention to Medicaid estate recovery policies that affect beneficiaries using long-term services and supports (LTSS). Commissioners on Friday approved recommendations to:

make estate recovery optional rather than required;
allow states with managed long-term services and supports to pursue recovery based on the cost of services where it is less than the capitation payment paid to a managed care plan; and
direct the Secretary of the U.S. Department of Health and Human Services (HHS) to establish minimum hardship waiver standards, including a minimum estate value threshold for estate recovery.

Next, the Commission considered recommendations for countercyclical financing adjustments in Medicaid. This would allow federal financial stimulus to be directed to states more quickly during economic downturns and provide states with greater budget predictability. The Commission approved a recommendation that Congress should adopt a statutory mechanism to amend the Social Security Act to provide an automatic Medicaid countercyclical financing model, using the prototype developed by the U.S. Government Accountability Office as the basis. The Commission also recommended this policy change should include:

an eligibility maintenance of effort requirement for the period covered by an automatic countercyclical financing adjustment;
an upper bound of 100 percent on countercyclical adjusted matching rates; and
exclusion of countercyclical adjusted federal matching rate from services and populations that receive special matching rates (e.g., for the new adult group) or are otherwise capped or have allotments (e.g., disproportionate share hospital payments, territories).

After a break on Thursday, Commissioners discussed a draft chapter for the March 2021 report on design considerations for creating a new program for dually eligible beneficiaries and reviewed a report to Congress by the U.S. Secretary of Health and Human Services (HHS) on Medicaid housing supports for individuals with substance use disorder (SUD). The Commission plans to send a letter to HHS and leadership of relevant congressional committees commenting on the Secretary’s report to Congress on Medicaid housing supports for people with SUD who are experiencing or at risk of homelessness.

Next, Commissioners heard a panel discussion on the outlook for state budgets and the implications for Medicaid with Emily Blanford, program principal at the National Conference of State Legislatures; Shelby Kerns, executive director for the National Association of State Budget Officers; and Susie Perez Quinn, government affairs director for the National Governors Association. * The day ended with a presentation on value-based payment for maternity services.

On Friday, Commissioners heard a panel discussion on how Medicaid serves people with intellectual or developmental disabilities with Sharon Lewis, a principal at Health Management Associates; Melissa Stone, director of Arkansas’ Division of Developmental Disabilities Services; and Elizabeth Weintraub, a senior advocacy specialist at the Association of University Centers on Disabilities. * Additional sessions focused on a congressionally mandated MACPAC study of non-emergency medical transportation (NEMT), which will be included in the June 2021 report to Congress. In addition, Commissioners heard a new analyses of care integration for dually eligible beneficiaries, and a discussion of potential new models for payment and coverage of high-cost specialty drugs. The meeting concluded with a discussion of mental health parity in Medicaid.

Supporting the discussion were the following briefing papers:

Because they serve so many Medicaid and CHIP patients – more than the typical hospital – MACPAC’s deliberations are especially important to Pennsylvania safety-net hospitals.

MACPAC is a non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on a wide variety of issues affecting Medicaid and the State Children’s Health Insurance Program. Find its web site here.

PA Safety Net Admin2021-02-02T06:00:35+00:00February 2nd, 2021|Federal Medicaid issues, Pennsylvania safety-net hospitals|Comments Off

SNAP Asks Congress to Help Hospitals Keep Provider Relief Fund Grants

Pennsylvania’s safety-net hospitals could lose some or all of their CARES Act Provider Relief Fund grant money and the Safety-Net Association of Pennsylvania is asking members of the state’s congressional delegation to intervene on their behalf to prevent it.

Safety-Net Association of Pennsylvania logo At issue are financial reporting requirements that at first directed hospitals to estimate their anticipated revenue losses and extra expenses associated with the COVID-19 pandemic in one way and then shifted to a new approach. The first grant distribution was based on the original reporting requirements, and now, hospitals fear that the change in reporting requirements could leave them vulnerable to a demand that they return some, much, or all of that grant money.

The Department of Health and Human Services announced one set of reporting requirement in June and then proposed modifying them in September. In response to widespread expressions of concern, including from SNAP, HHS revised those proposed changes – but not enough, according to many stakeholders, leaving them concerned that HHS would ask them to return some of their grant money. Now, SNAP is asking the same members of the Pennsylvania congressional delegation who asked HHS to reconsider the reporting requirements to do so again.

See SNAP’s letter to the delegation asking its members to sign onto a bipartisan letter asking HHS to revise its reporting requirements once again. Go here to see the letter members of Congress are being asked to sign.

PA Safety Net Admin2020-12-14T10:20:08+00:00December 14th, 2020|Coronavirus, COVID-19|Comments Off

SNAP Asks PA Delegation for COVID-19 Aid

SNAP has written to Pennsylvania’s congressional delegation to request additional COVID-19 legislation between now and the end of the year to help Pennsylvania safety-net hospitals respond to the health care and financial challenges posed by the pandemic.

In its letter, SNAP asked Congress for:

additional funding for the Provider Relief Fund for assistance to hospitals;
extension of the temporary moratorium on continued implementation of the 2011 Budget Control Act’s Medicare sequestration; and
the suspension of any other federal cuts for health care providers, such as the scheduled reduction of Medicaid disproportionate share (Medicaid DSH) allocations to the states.

Read SNAP’s message to Congress.

PA Safety Net Admin2020-12-08T06:00:24+00:00December 8th, 2020|Coronavirus, COVID-19, DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania Medicaid, Pennsylvania safety-net hospitals|Comments Off

SNAP Asks PA Congressional Delegation to Help Preserve Federal COVID-19 Aid for Hospitals

Protect the COVID-19 aid the federal government has given to Pennsylvania safety-net hospitals and others, SNAP has asked in a letter to members of Pennsylvania’s congressional delegation.

Safety-Net Association of Pennsylvania logo The letter refers to changes in how the federal Department of Health and Human Services wants hospitals to calculate the revenue they lost as a result of COVID-19 – the justification in part for the Provider Relief Fund payments hospitals have received through the CARES Act. In June, HHS told hospitals how to make that calculation but late last month it changed those directions in ways that could force many Pennsylvania safety-net hospitals to return some or even much of the federal aid they received.

In the letter, SNAP asks members of Pennsylvania’s congressional delegation to join a bipartisan letter asking HHS Secretary Alex Azar to restore the June instructions for calculating COVID-19-related lost hospital revenue.

Go here to read SNAP’s message to Congress.

PA Safety Net Admin2020-10-14T11:43:19+00:00October 14th, 2020|Coronavirus, COVID-19, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

Congress Gives Hospitals Medicaid DSH Relief

Medicaid DSH allocations to states will not be reduced right away thanks to a new continuing resolution to fund the federal government through December 11.

The Medicare disproportionate share allocation cuts to the states, mandated by the Affordable Care Act but delayed by Congress several times, were delayed again earlier this year but scheduled to take effect on November 11. With the latest continuing resolution, the cuts will be delayed yet another month.

SNAP worked hard to encourage Congress to include the Medicaid DSH delay in the continuing resolution, doing so most recently in this September 14 letter to members of Pennsylvania’s congressional delegation. Medicaid DSH payments are an important tool in helping Pennsylvania safety-net hospitals serve their predominantly low-income communities, so SNAP also is urging Congress to eliminate the Medicaid DSH cut entirely.

Learn more about the delay of Medicaid DSH cuts and other aspects of the continuing resolution that affect hospitals in the Healthcare Dive article “Providers win Medicare loan extension, DSH relief but lose other asks in stop-gap spending law.”

PA Safety Net Admin2020-10-08T13:00:02+00:00October 8th, 2020|Federal Medicaid issues, Medicaid supplemental payments|Comments Off

Wolf Presents Health Care Reform Proposal

Governor Wolf has unveiled a health care reform plan with the goal of making health care more affordable, supporting sustainable growth and transformations of health systems and corporations, and addressing health inequities across Pennsylvania. The plan includes three major components:

An Interagency Health Reform Council charged with developing recommendations on how to identify and capitalize on efficiencies in the existing health care system.
Regional Accountable Health Councils convened by Medicaid managed care organizations to assess community needs and develop regional transformation plans.
A Health Value Commission charged with setting spending targets for payers in the areas of primary care, behavioral health, and value-based purchasing. The commission also would perform public interest reviews of proposed large provider mergers, acquisitions, and changes in ownership.

Although it requires legislation to move forward, the third component of the governor’s plan appears to have the most potential to affect Pennsylvania safety-net hospitals

Learn more from the Wolf administration’s news release announcing the plan.

PA Safety Net Admin2020-10-07T06:00:03+00:00October 7th, 2020|Health care reform|Comments Off

Payer Mix to Change, Providers Anticipate

Health care providers expect to serve higher proportions of Medicaid and uninsured patients in the coming year, according to a new survey.

The shift will be driven by the COVID-19 pandemic, which as unemployment remains high is leading to fewer patients with commercial insurance and more with Medicaid or no insurance all, according to provider financial executives.

Such a shift would be especially challenging for Pennsylvania safety-net hospitals because they already serve higher proportions of Medicaid and uninsured patients than the typical community hospital.

Learn more about the reimbursement changes health care providers expect to see over the next twelve months in the Healthcare Dive article “Provider finance execs bracing for unfavorable shift in payer mix, survey finds.”

PA Safety Net Admin2020-10-05T06:00:21+00:00October 5th, 2020|Pennsylvania safety-net hospitals|Comments Off

MFAR is Dead

At least for now.

The controversial Medicaid Fiscal Accountability Regulation, slated for implementation this fall over the objections of many health care stakeholders, will not move forward at this time.

In a tweet earlier this week, Centers for Medicare & Medicaid Services Administrator Seema Verma wrote that

We’ve listened closely to concerns that have been raised by our state and provider partners about potential unintended consequences of the proposed rule, which require further study. Therefore, CMS is withdrawing the rule from the regulatory agenda.

If implemented, opponents maintained, the regulation would have:

Deprived states of important, established policy-making prerogatives.
Created major new administrative burdens for state governments and hospitals.
Inappropriately regulated financing of the state share of Medicaid spending.
Introduced new, unspecified standards for state Medicaid programs.

While CMS maintained that MFAR would have enhanced the transparency of state Medicaid programs, the rule’s opponents maintained that it could lead to a major reduction of resources for serving the Medicaid population.

SNAP was among those opponents, arguing that the regulation could have hurt Pennsylvania safety-net hospitals and others that serve low-income communities by inappropriately regulating how states can finance their Medicaid programs. CMS proposed the rule last November; SNAP submitted formal comments expressing its opposition in January; and SNAP rallied Pennsylvania’s congressional delegation to oppose the rule in February, March, and July.

It is worth noting that in “withdrawing the rule from the regulatory agenda,” Verma did not preclude the possibility of reintroducing MFAR at some point in the future.

Learn more from article “Trump administration backing off Medicaid rule that states warned would lead to cuts” in the online publication The Hill.