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PA Health Policy Update for June 27

The following is an update of selected state health policy developments in Pennsylvania from June 23 – 27.  (Some of the language used below is taken directly from state documents). 

General Assembly

The state House of Representatives and Senate convened in Harrisburg this week. The following is an overview of selected health care-related legislative activity that occurred.

  • The Senate unanimously voted to concur with the House’s amendments to Senate Bill 411, which provides the ability for the Pennsylvania Department of Health to create and utilize a stroke registry. The bill will now be sent to Governor Shapiro’s desk for his signature.
  • The Senate unanimously passed House Bill 640, which updates annual reporting requirements for the Department of Drug & Alcohol Programs (DDAP). The amended bill will now be sent back to the House for concurrence.
  • The Senate unanimously passed House Bill 309, which amends the Osteopathic Medical Practice Act to allow team physicians traveling internationally with their club or national team to treat their own players on site during games without needing a Pennsylvania medical license. The amended bill will now be sent back to the House for concurrence.
  • The Senate passed Senate Bill 715, which extends the Rare Disease Advisory Council’s sunset date to 2028. The bill was subsequently sent to the House and referred to the Health Committee.
  • The Senate passed Senate Bill 88, which provides coverage for supplemental screenings and diagnostic examinations without cost-sharing if a patient is at average risk or higher for breast cancer. The bill was subsequently sent to the House and favorably reported out of the Insurance Committee.
  • The House of Representatives passed House Bill 1100, which creates a grant program to provide eligible public-school entities with funding to acquire and distribute menstrual hygiene products. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 1445, which prohibits an insurer from denying what would otherwise be a service covered by the policy simply because the health care service was received in a school setting. The bill was subsequently sent to the Senate and referred to the Banking & Insurance Committee.
  • The House of Representatives passed House Bill 1590, which supports Pennsylvania’s implementation of a new federal Medicaid flexibility that waives the longstanding “four walls” requirement for outpatient behavioral health clinics. The bill will now be sent to the Senate for consideration.
  • The House of Representatives passed House Bill 583, which requires the Department of Human Services to establish a benefit package for dental services for Medicaid. The bill was subsequently sent to the Senate and referred to the Health & Human Services Committee.
  • The House of Representatives passed House Bill 1442, which places requirements on coroners to report Sudden Unexpected Death in Epilepsy (SUDEP). The bill was subsequently sent to the Senate and referred to the Local Government Committee.

The House and Senate will reconvene on Monday, June 30 for voting session.

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to notify providers that it will begin using Milliman Clinical Guidelines (MCG) as the screening guidelines to determine medical necessity for services, items, procedures, or level of care provided to Medical Assistance (MA) beneficiaries, effective July 18, 2025. 
  • DHS has also issued a Medical Assistance Bulletin to advise providers of changes to the MA program fee schedule. The department is adding and end-dating codes as a result of the 2025 updates published by the Centers for Medicare & Medicaid Services to the Healthcare Common Procedure Coding System (HCPCS). The changes are effective for dates of service on and after June 16, 2025. 
  • DHS has announced 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 beginning in Fiscal Year (FY) 2025-2026. Find additional information in this Pennsylvania Bulletin notice. 
  • The Office of Long-Term Living (OLTL) has shared an alert from the Centers for Medicare & Medicaid Services (CMS) about a fraud scheme that uses phishing fax requests, which falsely claim to be from CMS staff, to obtain medical records and documentation for auditing purposes.

Department of Health

The Department of Health (DOH), in partnership with the Pennsylvania Insurance Department and the Department of Human Services has launched a public survey looking for feedback on and suggestions for improving women’s health care across the commonwealth. The 10-minute survey is open through July 7 and focuses on women’s preventive health care, like health screenings, birth control, pregnancy care, and mental health services. 

Independent Fiscal Office

The Independent Fiscal Office (IFO) has published a revised document updating its prior impact of the Medicaid provisions included in the federal reconciliation bill package being negotiated by the U.S. Congress. 

Department of State 

The Department of State has announced that Pennsylvania will become a full participant in three health care compacts – physician, nursing, and physical therapy – beginning July 7. Click the respective compact link for more information regarding its implementation. 

Department of Aging

The Department of Aging has announced that it is conducting an evaluation of the PA Link to inform the design of a strategic plan to refresh and improve the program to better serve older adults, people with disabilities, and caregivers. Find additional information in this Pennsylvania Bulletin notice. 

State Board of Nursing 

The State Board of Nursing has released proposed regulations implementing Act 60 of 2021, which establishes title protection for certified registered nurse anesthetists (CRNA). Find the proposed rulemaking in this Pennsylvania Bulletin notice.

State Board of Pharmacy 

The State Board of Pharmacy has issued final-form rulemaking to effectuate Act 140 of 2020, which establishes criteria for pharmacy technician training programs as well as the standards of practice and registration fees for both pharmacy technicians and pharmacy technician trainees. Find the final rulemaking in this Pennsylvania Bulletin notice. 

Around the State  

The Philadelphia Inquirer has published an article about the Pennsylvania Medicaid program’s cost growth and its role in current state budget talks.

Stakeholder Meetings

PHC4 – Council Meeting – July 3

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced it will hold a council meet on July 3 at 10:00 a.m. PHC4 will also hold an Education Committee meeting on June 25. Find additional information in this Pennsylvania Bulletin notice. 

DOH – HIV Planning Committee – July 16-17

The Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee has announced it will hold a virtual public meeting on Wednesday, July 16 and Thursday, July 17. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

DOH – Renal Disease Advisory Committee – July 18

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, July 18.  The purpose of the meeting is to discuss new and ongoing issues relating to treatment of chronic renal disease and the Department of Health’s programs related to care and treatment. Find information on how to participate in this Pennsylvania Bulletin notice.

DOH – Special Pharmaceutical Benefits Program Advisory Council – July 31

The Special Pharmaceutical Benefits Program Advisory Council will hold a public meeting on Thursday, July 31. The SPBP Advisory Council will provide program guidance and recommendations to the Department’s SPBP in regard to the following: drug formulary; covered lab services; drug utilization review; clinical programs; eligibility and program management. Find details on how to participate in this Pennsylvania Bulletin notice.

2025-06-27T21:30:45+00:00June 27th, 2025|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for June 27

PA Health Policy Update for April 4

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

Governor Shapiro

The Shapiro administration has announced it joined a multi-state lawsuit against the Trump administration’s decision to cancel more than $500 million in public health grant funding that supported programs in the Department of Health, Department of Human Services, and the Department of Drug & Alcohol Programs. Find a copy of the lawsuit here and additional information in this press release. 

General Assembly

The state Senate convened in Harrisburg this week. The following is an overview of selected health care-related legislative activity.

  • The Senate passed Senate Bill 347, which prohibits the implementation of safe injection sites throughout the commonwealth, by a vote of 38-11. The bill will now be sent to the House of Representatives for consideration.
  • The Senate Institutional Sustainability & Innovation Committee held an informational hearing on Tuesday, April 1 examining the commonwealth’s life science sector and Pennsylvania’s innovation economy. A recording of the hearing is and testimony offered to the committee is viewable here.
  • The Senate Health & Human Services Committee held a voting meeting on Tuesday, April 1 and favorably reported, among other bills, Senate Bill 115, which provides skills competency examination opportunities to individuals seeking employment as a direct caregiver in lieu of successfully obtaining a high school diploma or GED equivalency, and Senate Bill 411, which implements a statewide stroke registry.

The Senate has now recessed until Monday, May 5. The state House of Representatives will reconvene Monday, April 7 through Wednesday, April 9. 

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers that DHS is implementing an alternative payment methodology for federally qualified health centers (FQHCs) and rural health clinics (RHCs) for a supplemental payment at the Medicaid fee schedule rate for a long-acting reversible contraceptive (LARC) device and its insertion, or the removal of a LARC device.

DHS has announced a recent audit uncovered recipient date of death discrepancies and a claims recovery was completed to recoup monies paid in error. DHS also reminded providers that it is their responsibility to resubmit a correctly completed claim if they are due payment for services provided prior to the date of death.  Find the notice here. 

Revenue Collection Update  

The Department of Revenue has announced Pennsylvania collected $6.2 billion in General Fund revenue in March, which was $70.0 million, or 1.1 percent, more than anticipated. Fiscal year-to-date General Fund collections total $33.2 billion, which is $34.3 million, or 0.1 percent, below estimate. 

Board of Pharmacy ission, 

The State Board of Pharmacy has published a notice in the Pennsylvania Bulletin of the current income levels necessary for participation in the Cancer Drug Repository program. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has published a notice in the Pennsylvania Bulletin that it has received the following final form rulemaking which will be considered at its May 15 meeting.

IRRC has also published a notice in the Pennsylvania Bulletin announcing it has issued comments to the State Board of Nursing regarding its proposed rule on nursing education programs issued January 25, 2025. Find IRRC’s comments here. 

Around the State

  • The Philadelphia Inquirer has published an article about Independence Blue Cross’, the largest health insurer in southeastern Pennsylvania, reported financial loss in 2024 due, in part, to Medicare and Medicaid rates. 
  • Governor Shapiro’s decision to join a multi-state lawsuit against the Trump administration’s decision to cancel public health grant funding was reported by the Pennsylvania Capital-Star. 
  • The Pennsylvania Capital-Star also published an article about the potential impact Medicaid cuts at the federal level may have on rural health care access. 
  • Spotlight PA has published an article about the Department of Aging’s decision to revise a policy that previously required the tracking of the cause of death for every adult who died during an active abuse or neglect investigation. 

Stakeholder Meetings

DHS – Pharmacy & Therapeutics (P&T) Committee – April 23

The Department of Human Services (DHS) has cancelled the April 23 Drug Utilization Board meeting and will instead hold an ad hoc P&T Committee meeting. Find registration information and details here. 

PHC4 – Meeting Schedule

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled a Payment Data Advisory Group meeting for April 10 at 1:00 p.m., a Data Systems Committee meeting for April 15 at 10:00 a.m., an Education Committee meeting for April 23 at 10:00 a.m., and a Council meeting for May 1, 2025, at 10:00 a.m. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.

2025-04-04T20:41:43+00:00April 4th, 2025|Financial, Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for April 4

PA Health Policy Update for Friday, July 8

The following is an update of selected state health policy developments in Pennsylvania for the week of July 5-8, 2022.  (Some of the language used below is taken directly from state documents.)

FY 2023 Budget Update

Governor Wolf and the General Assembly reached a final budget agreement for FY 2022-2023 this week.  In total the budget spends $45.3 billion, which is $1.3 billion more than the prior fiscal year’s budget.  The budget makes significant investments in education, housing, child tax credits, health care, and property tax and rent rebate programs.  It also allocates $2.1 billion to the state’s rainy day fund.  The following is an overview of budget-related bills and their status as of 2:00 p.m. on Friday, July 8.

  • Senate Bill 1100 is the General Appropriations bill.  The House passed the bill by a vote of 180-20 and the Senate subsequently concurred with House amendments by a vote of 47-3.  The bill has been presented to the governor for his signature.
  • The Fiscal Code bill is House Bill 1421, which is scheduled to be considered off the floor by the Senate Rules & Executive Nominations Committee Friday afternoon.
  • The Human Services Code bill is House Bill 1420It passed the House and Senate on Thursday but Governor Wolf vetoed the bill early Friday.  The Senate is expected to amend Human Services Code language, with the exception of the “Agency with Choice” delay, into the Fiscal Code later today and send it to the House for concurrence.
  • House Bill 1342 is the Tax Code bill.  The Senate and House both passed this yesterday.  It was presented to the governor and is currently awaiting his signature.

Governor Wolf

  • Governor Wolf signed House Bill 1561 and House Bill 1563 into law this week.  These bills, which are now Act 32 and 33 of 2022, amend the Mental Health Procedures Act and the Drug and Alcohol Abuse Control Act, respectively, to align them with HIPAA and give providers, facilities, and insurers the ability to share more easily patient mental health and substance use disorder treatment information.  Both pieces of legislation were presented to Governor Wolf for his signature.
  • Governor Wolf signed Senate Bill 861, which enters Pennsylvania into the EMS compact, on third and final consideration.  The bill has been presented to Governor Wolf for his signature.

General Assembly

The state House and Senate remain in session while they work to finalize the FY 2023 budget and pass legislation before they recess and are not scheduled to return to Harrisburg until mid-September.  The following is an overview of action taken by the General Assembly as of Friday, July 8 at 2:00 p.m.

  • The Senate voted to concur with House amendments to Senate Bill 818, which aligns the procedures permitted in ambulatory surgery centers with those permitted by the Centers for Medicare & Medicaid Services (CMS), and sent it to Governor Wolf for his signature.
  • The Senate passed House Bill 2679 on third and final consideration.  The bill, which is now on the governor’s desk, authorizes pharmacists and pharmacy interns to administer influenza and COVID-19 vaccines to individuals five and older.
  • The Senate passed House Bill 2604, which amends the requirement for health care facility ID badges to permit the use of health system names rather than specific licensed facility names.  The bill is now on the governor’s desk.
  • The Senate passed House Bill 2032, which states that a health care professional’s failure to report a victim’s injuries to law enforcement as required by the Crimes Code does not constitute a criminal offense when a sexual assault victim wishes to remain anonymous.  The bill is now on the governor’s desk for his signature.
  • The Senate passed Senate Bill 106 and sent it to the House for concurrence.  Senate Bill 106 includes a number of constitutional amendments, including one establishing that the state constitution does not grant the right to taxpayer-funded abortion or any other rights relating to abortion.
  • The Senate passed House Bill 2419, which expands access to outpatient psychiatric care via telemedicine, and sent it to Governor Wolf for his signature.
  • The House passed Senate Bill 1235, which prohibits the Department of Human Services from developing or using bidding or service zones that limit a health service corporation or hospital plan corporation contractor from submitting bids.  The bill is now on the governor’s desk.

Department of Human Services

  • The Department of Human Services (DHS) has proposed amending the state’s Human Services Code to enable individuals who are 14 years of age or older but under 18 years of age who meet the admission requirements to gain access to psychiatric rehabilitation services; to amend the diagnoses that enable an individual to obtain those services without use of the exception process; and to revise outdated language and add definitions of ”serious mental illness” and ”serious emotional disturbance” that align with definitions currently used by the Federal Substance Abuse and Mental Health Services Administration.  Learn more about what DHS has proposed and why it has proposed it in this Pennsylvania Bulletin notice.
  • DHS has published a Medical Assistance Bulletin announcing the addition of procedure code A4928 to the Medical Assistance fee schedule for disposable surgical masks dispensed to Medical Assistance beneficiaries effective with dates of service on and after July 1, 2022.  This bulletin applies to Medical Assistance-enrolled certified registered nurse practitioners, physician assistants, physicians, podiatrists, and medical suppliers that prescribe or dispense disposable surgical masks to Medical Assistance beneficiaries in the fee-for-service and managed care delivery systems.  Find the bulletin here.
  • DHS has published a series of Medical Assistance Bulletins to issue updated handbook pages that include the requirements for prior authorization and the type of information needed to evaluate the medical necessity of certain prescriptions.  These bulletins apply to all licensed pharmacies and prescribers enrolled in the Medical Assistance program.  The types of prescriptions covered by these bulletins are:
  • DHS has posted the minutes of the June 23 meeting of its Medical Assistance Advisory Committee meeting.  Find those minutes here.
  • DHS also has posted the minutes of the June 22 meeting of the Medical Assistance Advisory Committee’s consumer subcommittee.  Find those minutes here.

Department of Health

  • The Department of Health (DOH) has updated its guidance to hospitals in response to Act 30 of 2022, recently passed by the state legislature, which extends COVID-19-related waivers through October 31, 2022.  Among other things, this guidance addresses mandatory data reporting, suspension of services, alternative uses of hospital space, hospital-based laboratory analysis of COVID-19 tests, mandatory patient COVID-19 testing, and more.  For a complete review of the implications of Act 30 for hospitals, see this updated DOH guidance.
  • DOH has announced that its COVID-19 community-based testing sites will now offer three forms of free testing:  point-of-care tests where tests are performed and results are analyzed on-site; the distribution of at-home COVID-19 antigen tests; and continued administration of mid-nasal passage swab PCR testing.  The department currently operates testing locations in Berks, Blair, Centre, Clarion, Clinton, Erie, and Washington counties.  Learn more from this DOH announcement.
  • “COVID Alert PA,” DOH’s COVID-19 app that advises users of potential exposure to individuals diagnosed with COVID-19 and provides updated data on the state of the pandemic in Pennsylvania, has a new message informing users that “The current app will be discontinued on July 27, 2022.”

COVID-19:  By the Numbers

  • The daily average of newly reported COVID-19 cases fell 10 percent over the past week, to 2440 cases a day.
  • COVID-19-related deaths in the past week were the same as they were the week before.
  • The number of Pennsylvanians hospitalized with COVID-19 remained generally steady over the past week, as did the number of COVID-19 patients in hospital intensive care units and on ventilators.
  • Sixty-two of Pennsylvania’s 67 counties are currently experiencing high rates of community transmission of COVID-19, up from 35 counties last week.  The remaining five counties (Clarion, Forest, Potter, Sullivan, and Tioga) experienced a substantial rate of community transmission.

State Board of Pharmacy

The State Board of Pharmacy has published a final rule in the Pennsylvania Bulletin related to the administration of injectable medications, biologicals, and immunizations.  The rule allows pharmacists to administer influenza immunizations by injectable or needle-free delivery methods to children nine years of age and older.  Additionally, qualified and authorized pharmacy interns are permitted to administer injectable medications, biologicals, and immunizations to persons 18 years of age or older and administer influenza immunizations by injectable or needle-free delivery methods to children ages nine years and older under certain conditions.  Find the bulletin here.

Stakeholder Events

Department of Health – COVID-19 Therapeutics – July 12

The Department of Health, Department of Human Services, and Pennsylvania Emergency Management Agency will hold a webinar on COVID-19 therapeutics on Tuesday, July 12 at 4:00.  The webinar is intended for providers and facility administrators and will cover why, when, and
how to prescribe and obtain outpatient COVID-19 treatment and preventive therapies.  Learn more about the webinar and how to register to participate in this notice.

Department of Health – Newborn Screening and Follow-Up Technical Advisory Board – July 14

The Department of Health’s Newborn Screening and Follow-Up Technical Advisory Board will meet virtually on Thursday, July 14 from 10 a.m. until 1 p.m.  The agenda will include discussions about board member terms; updates from the Bureau of Family Health; payment options for additional conditions; research on dried blood spot specimens; a discussion on metachromatic leukodystrophy; and updates from the ethics, lysosomal storage disorders/X-ALD, cystic fibrosis, hemoglobinopathy, and critical congenital heart defects subcommittees.  For information about how to join the meeting, see this Pennsylvania Bulletin notice.

Department of Human Services – Long-Term Care Learning Network/Nursing Facilities – July 14

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a special populations webinar on “Filling the Day With Meaning:  Thinking Outside the Box.”  The webinar, to be held on Thursday, July 14 at 2:00, will seek to share with participants the benefits of meaningful engagement for residents living with dementia and is especially directed toward special population workers involved in recreational therapy, restorative team members, CNAs, and volunteers.  Learn about registration and how to join the webinar from this notice.

Department of Human Services – Medical Assistance Advisory Committee – Consumer Subcommittee – July 27

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, July 27 at 1:00.  Go here to register to participate.

Department of Human Services – Medical Assistance Advisory Committee – July 28

The Medical Assistance Advisory Committee will meet virtually on Thursday, July 28 at 10:00.  Go here to register to participate.

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