Pennsylvania safety-net hospitals Archives - Page 7 of 21 - Safety-Net Association of Pennsylvania

The Role of Medicaid in Addressing Social Determinants of Health

Medicaid can play a major role in addressing the social determinants of health.

Or so argues a recent post on the Health Affairs Blog.

According to the post, social determinants of health – income, education, decent housing, access to food, and more – significantly influence the health and well-being of individuals – including low-income individuals who have adequate access to quality health care. Medicaid, the post maintains, can play a major role in addressing social determinants of health.

The post outlines the role state Medicaid programs can play in addressing social determinants of health; describes tools for such action such as section 1115 Medicaid demonstration waivers; offers examples of efforts currently under way in some states; and presents suggestions for steps the federal government can take to facilitate such efforts.

Addressing social determinants of health is an especially important issue for Pennsylvania safety-net hospitals because they care for so many more Medicaid-covered low-income patients than the typical hospital in the state.

Learn more from the Health Affairs Blog post “For An Option To Address Social Determinants Of Health, Look To Medicaid.”

PA Safety Net Admin2019-07-12T09:43:03+00:00July 12th, 2019|Federal Medicaid issues, Pennsylvania safety-net hospitals, social determinants of health|Comments Off

DHS Secretary Says No to Medicaid Work Requirements

Pennsylvania will not seek federal permission to create a Medicaid work requirement, Department of Human Services Secretary Teresa Miller told a joint hearing of the State Senate Republican Policy Committee and Health and Human Services Committee this week.

Miller conveyed what a news release described as

…the Wolf Administration’s firm opposition to work requirements for Medicaid recipients and the administration’s work to expand access to education and training programs and services to support employment for people served by DHS’ programs.

In her testimony, Miller explained that

Our goal is always to set policy and implement programs that empower Pennsylvanians to live fulfilling lives, support themselves and their families, contribute to our local economies, and build stronger communities. This is not about opposition to work. We want all people to achieve a better quality of life and not be caught in an intergenerational cycle of poverty. The Wolf Administration is not simply opposed to a work requirement; we are committed to increasing opportunities for meaningful work and providing the whole-person supports we contend are needed.

A Medicaid work requirement could affect the Medicaid eligibility of patients served by Pennsylvania’s safety-net hospitals.

Learn more about Secretary Miller’s testimony in this Department of Human Services news release.

PA Safety Net Admin2019-06-14T06:00:07+00:00June 14th, 2019|Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

Administration Ramps Up Scrutiny of Immigrants’ Use of Public Benefits

Immigrants’ sponsors could be more likely to be held financially responsible for the cost of public benefits those immigrants receive under a new memorandum issued by the White House.

The requirement itself is not new; the purpose of the memorandum is to encourage federal agencies to enforce existing laws that state that, according to the memorandum,

…when an alien applies for certain means-tested public benefits, the financial resources of the alien’s sponsor must be counted as part of the alien’s financial resources in determining both eligibility for the benefits and the amount of benefits that may be awarded. Financial sponsors who pledge to financially support the sponsored alien in the event the alien applies for or receives public benefits will be expected to fulfill their commitment under law.

Among the means-tested public benefits programs at which this new directive is aimed are Medicaid, the Supplemental Nutrition Assistance Program (SNAP, formerly food stamps), and Temporary Assistance for Needy Families (TANF).

While the law already requires agencies to enforce immigrants sponsors’ legal financial responsibilities, the White House memorandum notes that it is not being enforced and directs the federal agencies involved to review and update their enforcement procedures.

Enforcement of this directive could result in fewer people applying for and being found eligible to receive Medicaid. If this occurs, it could be especially harmful to Pennsylvania safety-net hospitals that serve large immigrant communities, potentially leaving them unpaid for care they provide to such patients.

Learn more from the administration’s “Memorandum on Enforcing the Legal Responsibilities of Sponsors of Aliens.”

PA Safety Net Admin2019-06-06T06:00:12+00:00June 6th, 2019|Federal Medicaid issues, Pennsylvania safety-net hospitals|Comments Off

Medicaid Expansion Helps Pregnant Women and Their Babies

An intuitive assumption now has evidence to support it: Medicaid expansion has improved the health of pregnant women and their babies.

According to a new study from the Georgetown University Health Policy Institute’s Center for Children and Families,

…states that expand Medicaid improve the health of women of childbearing age: increasing access to preventive care, reducing adverse health outcomes before, during and after pregnancies, and reducing maternal mortality rates.

Better health for women of childbearing age also means better health for their infants. States that have expanded Medicaid under the Affordable Care Act saw a 50 percent greater reduction in infant mortality than non-expansion states.

The report notes that the number of uninsured women of childbearing age in Pennsylvania fell 49 percent during the three years after Pennsylvania expanded its Medicaid program. Significant numbers of these newly insured women are served by Pennsylvania safety-net hospitals.

Learn more, including specific health benefits enjoyed by pregnant women and their babies, in the Georgetown study “Medicaid Expansion Fills Gaps in Maternal Health Coverage Leading to Healthier Mothers and Babies.”

PA Safety Net Admin2019-06-03T16:17:14+00:00June 3rd, 2019|Affordable Care Act, Pennsylvania Medicaid policy, Pennsylvania safety-net hospitals|Comments Off

Medicaid DSH Delay Wins Bipartisan Support

More than 300 members of the U.S. House have joined a letter to House leadership urging a delay in Affordable Care Act-mandated cuts in Medicaid disproportionate share payments (Medicaid DSH).

The bipartisan letter notes that hospitals that receive Medicaid DSH funds cannot absorb the loss of revenue such a cut would bring. That cut, scheduled to begin in FY 2020, would amount to a $4 billion reduction in nation-wide Medicaid DSH spending in FY 2020 and an $8 billion reduction in each of FY 2021, FY 2022, FY 2023, FY 2024, and FY 2025.

SNAP was actively involved in urging Pennsylvania House members to join the letter. If implemented, the Medicaid DSH cuts would be especially harmful to SNAP members and all Pennsylvania safety-net hospitals – and to the low-income residents of the communities they serve.

See the bipartisan letter seeking a delay of Medicaid DSH cuts here.

PA Safety Net Admin2019-05-24T06:00:46+00:00May 24th, 2019|Affordable Care Act, DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments|Comments Off

SNAP Asks Congress for Help on Medicaid DSH

Prevent Medicaid DSH cuts: that is the message the Safety-Net Association of Pennsylvania conveyed to Pennsylvania’s congressional delegation this week.

In a message sent to every member of the U.S. House of Representatives from Pennsylvania, SNAP asked members to sign onto a letter to House Speaker Nancy Pelosi asking her to delay Affordable Care Act-mandated cuts in Medicaid disproportionate share payments (Medicaid DSH) that are scheduled to take effect in October of this year.

If implemented, the cut would hurt 179 of Pennsylvania’s 213 hospitals, including all safety-net hospitals, and cost the state approximately $240 million in Medicaid DSH revenue in FY 2020 and $480 million a year in FYs 2021 through 2025.

See the letter requesting action on Medicaid DSH cuts here and SNAP’s message to Pennsylvania’s congressional delegation here.

PA Safety Net Admin2019-04-24T14:49:48+00:00April 24th, 2019|Affordable Care Act, DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

Delay Medicaid DSH Cut, Pelosi Says

Medicaid DSH cuts should be delayed, House Speaker Nancy Pelosi (D-CA) told a gathering of hospital officials.

According to Speaker Pelosi,

DSH cuts threaten to erode the health of community hospitals, safety-net hospitals and rural hospitals, [affecting] the health of not only the families that rely on Medicaid, but any person who relies on these hospitals for care.

SNAP members all receive Medicaid DSH payments and would be harmed if the scheduled cut takes effect on October 1.

Learn more about Speaker Pelosi’s remarks in the Becker’s Hospital Review article “House speaker urges Congress to ease Medicaid payment cuts to hospitals serving low-income patients.”

PA Safety Net Admin2019-04-15T06:00:36+00:00April 15th, 2019|DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania safety-net hospitals|Comments Off

Medicare Advantage Permitted to Address Non-medical Needs

Starting in 2020, Medicare Advantage plans will be permitted to provide non-medical benefits to their chronically ill members.

As described in the Centers for Medicare & Medicaid Services’ “final call letter’ for 2020,

MA [Medicare Advantage] plans are not prohibited from offering an item or service that can be expected to improve or maintain the health or overall function of an enrollee only while the enrollee is using it. In other words, the statute does not require that the maintenance or improvement expected from an SSBCI [special supplemental benefits for the chronically ill] result in a permanent change in an enrollee’s condition. Items and services may include, but are not limited to: meals furnished to the enrollee beyond a limited basis, transportation for non-medical needs, pest control, air quality equipment and services, and benefits to address social needs, so long as such items and services have a reasonable expectation of improving or maintaining the health or overall function of an individual as it relates to their chronic condition or illness.

The CMS final call letter offers permission to Medicare Advantage plans to offer such services; it does not require them to do so.

Such a policy change could be highly beneficial to many of the low-income patients served by Pennsylvania safety-net hospitals, which have long sought help with addressing the social determinants of health that often bring patients to them but limit their ability to recover from their illnesses and injuries.

PA Safety Net Admin2019-04-12T06:00:43+00:00April 12th, 2019|Medicare, Pennsylvania safety-net hospitals, social determinants of health|Comments Off

Court Rejects 340B Cuts

A federal court has ruled that the Centers for Medicare & Medicaid Services overstepped its authority in reducing Medicare payments for prescription drugs covered by the section 340B prescription drug discount program.

While the court conceded that CMS has the authority to address 340B payments, it found that CMS’s drastic payment cuts, introduced in FY 2018, “…fundamentally altered the statutory scheme established by Congress…” for determining 340B payment rates.

The court suggested that CMS either change its methodology for determining 340B payments to justify the specific cuts it proposes or raise its objections with Congress, which created the program and has the authority to change it.

According to documents submitted to the court by the parties that filed the suit, eligible hospitals have seen their 340B payments reduced $1.6 billion since the cuts began in FY 2018. The court asked the federal government and those who filed the suit to suggest remedies for compensating participating hospitals for their losses.

The ruling has major implications for the Pennsylvania safety-net hospitals, most of which participate in the 340B program.

Learn more about the 340B litigation, the court’s ruling, and its impact in the New York Times story “Court Rejects Trump’s Cuts in Payments for Prescription Drugs.”

PA Safety Net Admin2019-01-11T06:00:43+00:00January 11th, 2019|Medicare, Pennsylvania safety-net hospitals|Comments Off

Medicaid MCOs Skimping on Care?

Medicaid MCOs may be skimping on care, according to a recent Kaiser Health News report.

According to Kaiser, for-profit companies that sub-contract with Medicaid managed care organizations to review requests for services often deny care to Medicaid patients to save money for the MCOs that employ them and to benefit themselves financially.

The Kaiser article presents examples of companies that have been identified engaging in such practices, explains how they go about their work, and outlines the dangers to Medicaid recipients posed by such practices.

Because they serve so many more Medicaid patients than the typical hospital, Pennsylvania safety-net hospitals, their patients, and the communities they serve can be greatly affected by such practices.

Learn more in the Kaiser Health News article “Coverage Denied: Medicaid Patients Suffer As Layers Of Private Companies Profit.”

PA Safety Net Admin2019-01-09T15:54:59+00:00January 9th, 2019|Pennsylvania Medicaid, Pennsylvania safety-net hospitals|Comments Off

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