SNAPShots

SNAPShots

PA Health Policy Update for September 20

The following is an update of selected state health policy developments in Pennsylvania from September 16 – 20.  (Some of the language used below is taken directly from state documents). 

Governor Shapiro 

This week the Shapiro administration recognized September as Suicide Prevention Month. Leaders from multiple state agencies, including Department of Human Services Secretary Dr. Val Arkoosh, highlighted the various resources dedicated to suicide prevention and efforts underway to address behavioral health challenges. Find more information in this press release. 

General Assembly

The Senate convened in Harrisburg for session this week. Following is a selection of relevant health care-related legislative activity.

  • The Senate passed Senate Bill 1255, which amends the definition of an “advanced practice professional” to include a physician assistant in the Outpatient Psychiatric Oversight Act. The bill will now be sent to the House of Representatives for consideration.
  • The Senate Consumer Protection & Professional Licensure Committee met on Tuesday, September 17 and favorably reported, among other bills, Senate Bill 1281, which establishes scope of practice and licensing standards for medical imaging specialists, radiation therapists, and radiology assistants.
  • The Senate Aging & Youth and Banking & Insurance Committees met on Wednesday, September 18 for a joint informational hearing on protecting seniors from financial exploitation and updating the state’s Older Adult Protective Services Act. The meeting’s agenda, testimony, and a recording of the are viewable here.

The state House of Representatives and Senate will be recessed next week. Both chambers will reconvene for voting session on Monday, September 30. 

Department of Human Services 

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to advise providers that it will be increasing fees for certain ophthalmology services on the Medical Assistance (MA) program fee schedule effective for dates of service on or after September 15, 2024.
  • The Office of Mental Health & Substance Abuse Services (OMHSAS) has announced it will need to delay the addition of Psychiatric Rehabilitation Services (PRS) to Pennsylvania’s Medicaid state plan until 2026. PRS will continue to be covered as an in-lieu of service within the Behavioral Health HealthChoices program while OMHSAS continues to work on implementation.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through October. Find the updated calendar here.
  • DHS has issued revisions to the participating drug company list for the Medicaid Drug Rebate Program. The revisions are viewable here.
  • DHS has published notice of its intent to make additional supplemental ventilator care and tracheostomy care payments to qualified non-public and county skilled nursing facilities, which remain open as of July 11, 2024, that qualified for supplemental ventilator care and tracheostomy care payments in FY 2014-2015 with a percentage of Medical Assistance recipient residents who required medically necessary ventilator care or tracheostomy care greater than 90%. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced that it intends to continue to make Medical Assistance Day One Incentive (MDOI) payments to qualified non-public nursing facilities for FY 2024-2025. The MDOI payments will provide incentives to nursing facilities to provide services to individuals who are Medicaid eligible on the day of admission. The MDOI payments are intended to encourage non-public nursing facilities to increase access to care for the poor and indigent citizens of this commonwealth. Find additional information in this Pennsylvania Bulletin notice. 

Department of Health 

The Department of Health (DOH) has announced skilled nursing facilities throughout the commonwealth are eligible to train up to two staff members through a DOH-funded infection prevention and control training course offered by the Association for Professionals in Infection Control and Epidemiology (APIC). The course is available through December 2024 and continuing education credits may be available. Click here for more information and to enroll in the program. 

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced that it has begun studying the prevalence and impact of non-compete agreements in Pennsylvania as directed by Act 74 of 2024 (formerly House Bill 1633). PHC4 is collecting public comments for analysis and inclusion in its final report. Comments are due by October 21, 2024. Find details on how to comment in this Pennsylvania Bulletin notice. 

PHC4 has published a list of diseases, procedures, and medical conditions for which it will require data collection. Find the comprehensive list in this Pennsylvania Bulletin notice. 

Independent Regulatory Review Commission 

The Independent Regulatory Review Commission (IRRC) has published a notice in the Pennsylvania Bulletin of actions taken at its September 11 meeting, including its review of existing regulations and determination that some are outdated and no longer in the public interest. Among those IRRC determined to be outdated are clinical laboratory, health care facility identification badge, and hospital regulations. IRRC’s comprehensive review, including its recommendations, can be found here. 

IRRC has announced it received final form regulations from the State Board of Nursing that address requirements for reactivation of a license and add provisions related to licensure by endorsement, provisional endorsement license, and licensure by endorsement fee. IRRC will consider these regulations at its October 24 meeting. Find a copy of the final form regulations here.

Around the State 

  • Harold Brubaker has written an article for The Philadelphia Inquirer about an increase in medical malpractice filings in Philadelphia due to a change that has allowed cases to be filed in Philadelphia even if the incident occurred outside the city.
  • The Philadelphia Inquirer also reported about St. Luke’s University Health Network’s discussions to acquire Grand View Health in Bucks County.
  • The Tribune-Review has published an article about the use of artificial intelligence (AI) in the medical field. 

Stakeholder Events

DHS – Consumer Sub-MAAC – September 25

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 25 at 1:00 p.m. The meeting will be held virtually. Register to participate here.

DHS – Medical Assistance Advisory Committee – September 26

The Medical Assistance Advisory Committee (MAAC) will hold a public meeting on September 26 at 10:00 a.m. The meeting will be held virtually. Register to participate here.

DOH – Renal Disease Advisory Committee – October 18

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, October 18 from 10:00 a.m. to 12:00 p.m. The meeting will be held in person and virtually. Find additional information in this Pennsylvania Bulletin notice.

2024-09-20T19:15:56+00:00September 20th, 2024|Financial, Governments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for September 20
Read More

PA Health Policy Update for August 9

The following is an update of selected state health policy developments in Pennsylvania from August 5 – 9.  (Some of the language used below is taken directly from state documents). 

General Assembly

The state House of Representatives and Senate are recessed until Monday, September 23 and Monday, September 16, respectively. 

Department of Human Services

The Department of Human Services (DHS) has issued two Medical Assistance bulletins relating to prior authorization for pharmacy services.

Department of Health 

The Department of Health (DOH) has announced it distributed 50,000 xylazine wound care kits to provide relief for people with xylazine-associated wounds. The kits have been distributed to more than 200 medical and harm reduction organizations across the commonwealth. Find additional information in this press release. 

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has released a new research brief, Hospitalizations for Pennsylvania Children with Cancer. The research brief examines inpatient hospitalizations for Pennsylvania children who were admitted to a Pennsylvania general acute care hospital with a diagnosis of cancer. 

Insurance Department 

The Pennsylvania Insurance Department has announced that 2025 rate changes requested by insurance companies currently operating in Pennsylvania’s individual and small group markets are now available here. Find additional information in this press release. 

Around the State   

  • The Philadelphia Inquirer has published an article about Crozer Health’s potential sale to New Jersey-based CHA Partners, and its conversion back into a non-profit. WHYY also wrote an article about the planned sale 
  • Vice President Kamala Harris’ decision to pick Minnesota Governor Tim Walz as her running mate over Pennsylvania Governor Josh Shapiro received a lot of media coverage this week, including this article published by The Philadelphia Inquirer.
  • PennWatch has published an article about the Shapiro administration’s efforts to distribute 50,000 xylazine wound care kits across the state. 

Stakeholder Events

DHS – Dual Diagnosis Conference – September 11

The Office of Developmental Programs (ODP) and the Office of Mental Health and Substance Abuse Services (OMHSAS) have announced the Dual Diagnosis Conference Services, “Insidious Trauma: Context, Impact, and Considerations for Care.” The conference will be held September 11 from 10:00 a.m. to 1:00 p.m. Find additional information and registration details here. 

DHS – OLTL Transportation Summit – September 17

The Office of Long-Term Living (OLTL) will host a transportation summit on Tuesday, September 17 from 9:00 a.m. to 12:00 p.m. The summit is an open forum for anyone interested in discussing transportation related issues in the Community HealthChoices (CHC) program. The summit will be held virtually. Find registration details here. 

DOH – Spinal Cord Injury Research Advisory Committee – September 18

The Spinal Cord Injury Research Advisory Committee will hold a public meeting on Wednesday, September 18 from 9:30 a.m. to 11:00 a.m. The meeting will be held in person at Saint John’s Evangelical Lutheran Church (910 Allentown Road, Sellersville, PA 18960) and virtually by means of Microsoft Teams. Find additional details in this Pennsylvania Bulletin notice.

2024-08-10T00:03:40+00:00August 9th, 2024|Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for August 9
Read More

PA Health Policy Update for June 28

The following is an update of selected state health policy developments in Pennsylvania from June 24 – 28.  (Some of the language used below is taken directly from state documents). 

FY 2024-2025 Budget Update 

Governor Shapiro and legislative leaders continue to work on a final Fiscal Year (FY) 2024-2025 budget agreement. The state House of Representatives and Senate have both recessed until Monday, July 1; however, in remarks late Thursday afternoon, Senate Majority Leader Joe Pittman and Minority Leader Jay Costa both signaled optimism that an agreement would be reached in the near future. 

General Assembly

The state House of Representatives and Senate were in Harrisburg for session this week. The following is an overview of selected health care-related legislative activity.

  • The Senate unanimously passed House Bill 1754, which requires public and private insurers to cover biomarker testing. The bill was subsequently sent to Governor Shapiro’s desk for his signature.
  • The House of Representatives passed Senate Bill 739, which provides for coverage of telemedicine services, by a vote of 194-8. The Senate subsequently concurred with the House’s amendments and sent the bill to Governor Shapiro’s desk for his signature.
  • The House of Representatives passed House Bill 1993, which seeks to reform certain practices by pharmacy benefit managers (PBMs) that have an adverse impact on pharmacies and patients, by a vote of 194-8. The bill will now be sent to the Senate for consideration.
  • The Senate unanimously passed Senate Bill 965, which provides Medicaid coverage for rapid whole genome sequencing under certain conditions. The bill was subsequently received in the House and referred to the Health Committee.
  • The Senate unanimously passed on Senate Bill 840, which creates an Alzheimer’s Disease and related disorders division within the Department of Aging and establishes an Alzheimer’s, Dementia and Related Disorders Advisory Committee. The bill was subsequently received in the House and referred to the Health Committee.
  • The House unanimously passed House Bill 2403, which updates annual reporting requirements for the Department of Drug & Alcohol Programs (DDAP). The bill will now be sent to the Senate for consideration.
  • The House unanimously passed House Bill 2400, which creates an Alzheimer’s Disease and related disorders division within the Department of Aging and establishes an Alzheimer’s, Dementia and Related Disorders Advisory Committee. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 2198, which caps the fees for obtaining electronic medical records, by a vote of 137-65. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 2268, which provides coverage for speech therapy for stuttering, by a vote of 181-21. The bill will now be sent to the Senate for consideration.
  • The House passed House Bill 1140, which expands access to contraceptives, by a vote of 133-69. The bill will now be sent to the Senate for consideration.
  • The House Children & Youth Committee met on Tuesday, June 25 and favorably reported House Bill 1425, which directs the Department of Human Services to develop a five-year plan to offer evidence-based maternal home visiting programs for eligible families. A recording of the meeting is viewable here.
  • The House Health Committee met on Wednesday, June 26 and favorably reported House Bill 2344, which imposes more reporting requirements and additional oversight on health care facility mergers and acquisitions, and House Bill 2382, which establishes a rural health care grant program to incentive licensed health care practitioners to practice in rural areas. Find a recording of the meeting here.
  • The Senate Health & Human Services Committee met on Thursday, June 27 and reported with “no recommendation” the nomination of Dr. Debra Bogen for Secretary of the Department of Health. Find a recording of the confirmation hearing here. 

The House and Senate are currently recessed for the weekend. Both chambers will return to Harrisburg on Monday, July 1. The House will convene at 12:00 p.m. and the Senate will convene at 3:00 p.m. 

Department of Human Services

  • The Department of Human Services (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 FY 2024-2025. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has announced the proposed annual case-mix per diem payment rates for FY 2024-2025 for non-public and county nursing facilities that participate in the Medicaid program. Find additional information in this Pennsylvania Bulletin notice.
  • DHS has issued Provider Quick Tip #263 with information about the availability of an electronic submission process for long-term care (LTC) 180-day exception requests and other claims requiring documentation.
  • DHS has issued a Remittance Advice Alert notifying providers of changes to the electronic funds transfer (EFT) procedure effective June 28, 2024.

Department of Health 

The Department of Health (DOH) has released an updated staffing calculation tool to assist nursing home providers with compliance with new standards that come into effect on July 1, 2024. 

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced the release a report that includes state-wide data and facility-specific information about the financial health of Pennsylvania’s general acute care hospitals for fiscal year 2023. Financial Analysis, Volume One, is the first in a three-part series of financial reports produced annually by PHC4.  

Stakeholder Events   

Pennsylvania Health Care Cost Containment Council – July 10 and 11

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled an executive committee meeting on July 10 at 11:30 a.m. and a council meeting on July 11 at 10:00 a.m. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – HIV Community Prevention Planning Committee – July 10 and 11

The Statewide HIV Planning Group will hold public meetings on Wednesday, July 10 and Thursday, July 11. The meetings will be held in person and virtually. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Newborn Screening & Follow-Up Advisory Board – July 18

The Newborn Screening and Follow-Up Technical Advisory Board, established under the Newborn Child Testing Act, will hold a public meeting on Thursday, July 18 from 10:00 a.m. to 1:00 p.m. The meeting will be conducted in person. Find additional details on how to participate in this Pennsylvania Bulletin notice.

DOH – Renal Disease Advisory Committee – July 19

The Renal Disease Advisory Committee will hold its quarterly public meeting on Friday, July 19 from 10:00 a.m. to 12:00 p.m. 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 additional details here.

DHS – Special Pharmaceutical Benefits Program Advisory Council – July 25

The next Special Pharmaceutical Benefits Program (SPBP) Advisory Council Meeting will be held virtually on Thursday, July 25 at 10:00 a.m. Please let us know if you would like the virtual meeting details.

DOH – Brain Injury Advisory Board – August 2

The Brain Injury Advisory Board will hold a public meeting on Friday, August 2 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person at the Pennsylvania Training and Technical Assistance Network. Find additional details here.

2024-06-28T20:16:51+00:00June 28th, 2024|Governments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations|Comments Off on PA Health Policy Update for June 28
Read More

PA Health Policy Update for April 26

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

2024 Primary Election Update 

Pennsylvania held its 2024 primary election on Tuesday, April 23. In the race for Attorney General, former Auditor General Eugene DePasquale won the Democratic nomination and York County District Attorney David Sunday won the Republican nomination. Current State Representative Malcolm Kenyatta won the Democratic nomination for Auditor General. He will face the incumbent Auditor General Tim DeFoor in the fall. Lastly, Erin McClellan from Allegheny County won the Democratic nomination to challenge incumbent State Treasurer Stacy Garrity in the general election this fall. Find the comprehensive election results, including those for state House of Representative and Senate, here. 

General Assembly

The House Health Committee and the Liquor Control Committee held a joint informational hearing on Thursday, April 25 examining public health challenges of cannabis legalization. A recording of the hearing is viewable here.

The state House of Representatives and Senate will convene for voting session in Harrisburg next Monday, April 29 through Wednesday, May 1. Following is an overview of selected health care-related legislative activity currently scheduled next week.

  • The House Human Services Committee will meet on Monday, April 29 at 10:00 a.m. in Room 523 of the Irvis Office Building to consider, among other bills, House Bill 1783, which requires the development of opioid-related overdose public information, and House Bill 2137, which establishes the Maternal and Newborn Supply Kit Program. The meeting will be livestreamed here.
  • The House Health Committee will meet on Tuesday, April 30 at 9:30 a.m. in Room 140 of the Main Capitol to consider the following bills.
    • House Bill 2127, which requires clinicians to distribute information related to postpartum depression and conduct a postpartum screening for depression.
    • House Bill 2208, which strengthens the Department of Health’s oversight of laboratories that test medical marijuana.
    • Senate Bill 721, which establishes the Women, Infants and Children (WIC) State Advisory Board.

The meeting will be livestreamed here.

  • The House Aging & Older Adult Services Committee will hold an informational meeting on Tuesday, April 30 at 10:00 a.m. regarding local Area Agencies on Aging. The meeting will take place in Room B31 of the Irvis Office Building. The meeting will also be livestreamed here.
  • The House Human Services Committee will hold an informational meeting on Wednesday, May 1 regarding performance-based contracting for the Department of Human Services’ Office of Developmental Programs. The meeting will take place in Room 515 of the Irvis Office Building. The meeting will also be livestreamed here. 

Department of Health 

The Department of Health (DOH) has released a schedule of five public comment sessions to provide interested stakeholders an opportunity to comment on the development of the 2025 plan for the state’s Special Supplemental Nutrition Program for Women, Infants, and Children (i.e., WIC Program). Find the schedule and details on how to participate in this Pennsylvania Bulletin notice. 

Department of Human Services 

The Department of Human Services (DHS) has announced changes to the Medical Assistance (MA) program fee schedule based upon provider requests and clinical review. DHS is adding procedure codes for ECG services and removing prior authorization for fetal congenital abnormality testing. The changes are effective for dates of service on and after April 29, 2024. 

Department of Drug & Alcohol Programs 

The Department of Drug & Alcohol Programs (DDAP) has announced a virtual webinar in collaboration with the Center for Substance Abuse Treatment (CSAT) on strategies for preventing and treating xylazine in a behavioral health or clinical setting. It will be held virtually on Wednesday, May 8 at 3:00 p.m. The webinar is open to the public, but registration is required. 

Stakeholder Events  

DOH – HIV Community Prevention Planning Committee – May 1

The Human Immunodeficiency Virus (HIV) Prevention Planning Committee will hold a public meeting on Wednesday and Thursday, May 1-2, 2024. The meeting will be held in person and virtually. Find additional details in this Pennsylvania Bulletin notice. 

PHC4 – Council Meeting – May 2

The Pennsylvania Health Care Cost Containment Council (PHC4) has announced it will hold a council meeting on May 2 at 8:30 a.m. Find additional information in this Pennsylvania Bulletin notice. 

DOH – Organ Donation Advisory Committee – May 2

The Organ Donation Advisory Committee will hold a public meeting on Thursday, May 2 from 10:15 a.m. to 1:15 p.m. The meeting will be held virtually and in person. Find additional details in this Pennsylvania Bulletin notice. 

DOH – Brain Injury Advisory Board – May 3

The Brain Injury Advisory Board will hold a public meeting on Friday, May 3, 2024 from 10:00 a.m. to 3:00 p.m. The meeting will be held in person. Find additional details in this Pennsylvania Bulletin notice.

2024-04-26T20:57:46+00:00April 26th, 2024|Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off on PA Health Policy Update for April 26
Read More

PA Health Policy Update for April 5

The following is an update of selected state health policy developments in Pennsylvania from April 1 – 5.  (Some of the language used below is taken directly from state documents). 

General Assembly 

The Senate Aging & Youth Committee held an informational hearing on Wednesday, April 3 to examine challenges facing Pennsylvania’s children and youth services agencies. A recording of the hearing and copies of testimony provided to the committee are viewable here.

The state House of Representatives and Senate will reconvene for session Monday, April 8 through Wednesday, April 10. Following is an overview of selected health care-related legislative activity currently scheduled next week.

  • The House Human Services Committee will meet on Monday, April 8 at 9:00 a.m. to consider House Resolution 373, which recognizes the week of April 11 through 17, 2024, as “Black Maternal Health Week” in Pennsylvania. The meeting will be held in Room 515 of the Irvis Office Building.
  • Following its voting meeting, the House Human Services Committee will hold an informational meeting on the delivery of quality home care services under Community HealthChoices. The meeting will be livestreamed here.
  • The House Health Committee will hold an informational meeting on Thursday, April 11 on advancing social equity through cannabis legalization. The meeting will be held in Room 60 of the East Wing and livestreamed here. 

Department of Human Services

After one year of processing Medicaid eligibility redeterminations following the end of pandemic-related continuous eligibility, the Department of Human Services (DHS) has reported that less than 600,000 applications are left to be processed and it should be completed with this effort by June 30.

About 70 percent of individuals remained eligible for Medicaid following their redetermination. To continue assisting Medicaid recipients with their annual redeterminations, providers are reminded to:

Department of Drug & Alcohol Programs

The Department of Drug & Alcohol Programs (DDAP) has provided an update on certification entities. Clinical supervisors and counselors that provide clinical treatment services in licensed substance use disorder (SUD) treatment facilities have a number of ways to meet minimum qualifications. One of those ways is full certification by a statewide certification body that is a member of a national body. In Pennsylvania, the Pennsylvania Certification Board (PCB) has historically been one of the entities that provides that certification. In addition to PCB, the newly developed Pennsylvania Certification Commission for Addiction Professionals (PCC AP), which is part of the Pennsylvania Association of Addiction Professionals, an affiliate of the National Association of Addiction Professionals (NAADAC), is also an option for certification for clinical counselors and supervisors.  

Department of Insurance

The Department of Insurance has published guidance on how insurers should govern the development, acquisition, and use of certain artificial intelligence (AI) technologies. This department has also informed insurers of the type of information and documentation that the department may request during an investigation or examination of any insurer regarding its use of the technologies and AI systems. Find additional information in this Pennsylvania Bulletin notice. 

Revenue Collection Update 

The Department of Revenue has announced that Pennsylvania collected $6.3 billion in General Fund revenue in March, which was $289.9 million, or 4.8 percent, more than anticipated. Fiscal year-to-date General Fund collections total $32.8 billion, which is $366.0 million, or 1.1 percent, above estimate. 

Stakeholder Events 

PHC4 – Meeting Dates

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled the following meetings.

  • Data Systems Committee meeting on April 17, 2024, at 9:00 a.m.
  • Council meetings on May 4 at 8:30 a.m. and July 11 at 10:00 a.m.
  • Payment Data Advisory Group meetings on April 18, May 23, and June 20 at 10:00 a.m.

Agendas will be available 24 hours in advance here. Find details on how to register and participate here. 

Patient Safety Authority – April 25

The Patient Safety Authority will hold a meeting of the authority’s board on Thursday, April 25 at 1:00 p.m. The meeting will be held virtually. Find details on how to participate in this Pennsylvania Bulletin notice. 

DOH – Special Pharmaceutical Benefits Program Advisory Council – April 25

The Statewide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a public meeting on Thursday, April 25, 2024, from 10:00 a.m. to 3:00 p.m. The meeting will be held in person and virtually. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2024-04-06T06:34:47+00:00April 5th, 2024|Medicaid Eligibility Redetermination , Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for April 5
Read More

PA Health Policy Update for January 12

The following is an update of selected state health policy developments in Pennsylvania from January 8 – 12.  (Some of the language used below is taken directly from state documents). 

General Assembly 

  • The state House of Representatives and Senate have released their respective FY 2024-2025 budget hearing schedules. Find the House Appropriations Committee’s schedule here and the Senate Appropriations Committee’s schedule here. 

Department of Human Services

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin to inform providers that, effective February 1, 2024, doulas may enroll in the Medical Assistance (MA) Program, which will enable MA managed care organizations (MCOs) to enter into network agreements with doulas. The bulletin also contains information on provider enrollment.
  • DHS has updated its calendar of mailing dates for Remittance Advices and corresponding electronic transfers and checks through February 2024. Find the updated calendar here. 

Department of Health

DOH has requested input from stakeholders on what the state’s priorities should be for its Title V Maternal and Child Health Services Block Grant, which is intended to improve the health and wellbeing of mothers, infants, children, and youth, including children and youth with special health care needs, and their families. Interested stakeholders can find additional information and details on how to submit feedback here. 

Board of Nursing 

The State Board of Nursing, along with DHS and DOH, has issued a joint statement of policy to clarify nursing standards and qualifications in the commonwealth for licensed practical nurses (LPNs) and registered nurses (RNs) as it relates to the Nurse Licensure Compact (NLC). Find additional information in this Pennsylvania Bulletin notice. 

Insurance Department 

The Pennsylvania Insurance Department (PID) has announced the establishment of a state-administered independent appeal process that allows Pennsylvanians to submit for an independent external review if they believe their insurer wrongly denied a claim for covering medical service, treatment, or other items. This is part of Act 146 of 2022, which reformed the state’s prior authorization and step therapy procedures. 

PID has also announced that Pennie’s open enrollment period for 2024 health care coverage will be extended until January 19. Pennie is Pennsylvania’s official health insurance marketplace. 

Department of Drug & Alcohol Programs 

The Department of Drug & Alcohol Programs (DDAP) has announced the Drug-Free Communities Program, which provides community coalitions with grant funding for substance use prevention efforts, will release its FY 2024 notice of funding opportunities on www.grants.gov in February 2024.   

Pennsylvania Health Care Cost Containment Council 

The Pennsylvania Health Care Cost Containment Council (PHC4) has released a new report – COVID-19, The Impact on Health Care in Pennsylvania – examining how the coronavirus pandemic affected Pennsylvania and its health care system. Find additional information in this press release issued by PHC4. 

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

DHS – Consumer Subcommittee of the MAAC – January 24

The Consumer Subcommittee of the Medical Assistance Advisory Committee (MAAC) will be held on Wednesday, January 24 at 1:00 p.m. Find details on how to participate here. 

DHS – Medical Assistance Advisory Committee – January 25

The MAAC will hold a public meeting on Thursday, January 25 at 10:00 a.m. The meeting will be held virtually. Find details on how to participate here.

Patient Safety Authority – January 25

The Patient Safety Authority has announced that it will hold a virtual public meeting on Thursday, January 25 at 1:00 p.m. Additional details on how to participate can be found in this Pennsylvania Bulletin notice. 

DOH – Special Pharmaceutical Benefits Program Advisory Council – January 25

The state-wide Special Pharmaceutical Benefits Program (SPBP) Advisory Council will hold a public meeting on Thursday, January 25 from 10:00 a.m. to 12:00 p.m. Find additional information and details on how to participate in this Pennsylvania Bulletin notice.

2024-01-12T23:48:27+00:00January 12th, 2024|Medicaid Eligibility Redetermination , Medical Assistance Advisory Committee, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid|Comments Off on PA Health Policy Update for January 12
Read More

PA Health Policy Update for September 29

The following is an update of selected state health policy developments in Pennsylvania from September 25 – 29.  (Some of the language used below is taken directly from state documents.) 

Governor Shapiro

Governor Shapiro announced the launch of a new economic development strategy this week that aims to make Pennsylvania a leader in job creation and innovation. Tuesday’s announcement was the first step in creating the state’s first comprehensive economic growth strategy in almost two decades.  The strategy will be an assessment of the areas of strength, an analysis of barriers to growth, and concrete goals and initiatives to guide policymaking and investment decisions moving forward. 

General Assembly 

  • The state House of Representatives convened in Harrisburg this week. The following is an overview of selected health care focused legislative activity.
    • The Health Committee met on Wednesday, September 27 and favorably reported, among other bills and resolutions, House Resolution 143, which directs the Joint State Government Commission to study Pennsylvania’s response to COVID-19. Find a recording of the hearing here.
    • The Aging & Older Adult Services Committee met on Wednesday, September 27 and favorably reported, among other bills, House Bill 1527, which increases the personal needs allowance for Medical Assistance-eligible residents living in nursing facilities, and 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. Find a recording of the hearing here.
  • The state House of Representatives and Senate will convene in Harrisburg next Monday, October 2 through Wednesday, October 4 for voting session.
  • The House Health Subcommittee on Health Facilities will hold an informational meeting on Wednesday, October 4 at 9:00 a.m. to examine hospital closures and consolidation.
  • The House Human Services Committee and Aging & Older Adult Services Committee will hold a joint informational meeting on Wednesday, October 4 at 9:00 a.m. on personal care homes and assisted living facilities.  

Department of Human Services

The Department of Human Services (DHS) has published a notice in the Pennsylvania Bulletin announcing the addition of new procedures codes to the Medical Assistance (MA) program for vaccine administration.

DHS has issued a Medical Assistance Bulletin to notify dental providers of updates to the 2023 Pediatric Dental Periodicity Schedule.

Insurance Department 

The Pennsylvania Insurance Department has announced the 2024 individual and small group Affordable Care Act (ACA) health insurance rates. The open enrollment period for Pennsylvania’s state-based insurance exchange, Pennie, will be November 1 to December 15.

Pennsylvania Health Care Cost Containment Council

The Pennsylvania Health Care Cost Containment Council (PHC4) has published its annual list of 35 diseases, procedures, and medical conditions for which data shall be required. Find the comprehensive list in this Pennsylvania Bulletin notice. 

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 

Pharmaceutical Assistance Advisory Board – October 2

The Pharmaceutical Assistance Advisory Board will hold a virtual meeting on Monday, October 2 from 10:00 a.m. to 11:30 a.m. Find information on how to participate in this Pennsylvania Bulletin notice.

Interstate Commission of Nurse Licensure Compact Administrators – October 17

The Interstate Commission of Nurse Licensure Compact Administrators will host a free webinar on October 17 from 3:00 – 4:00 p.m. to discuss the nurse licensure compact and new rules taking effect in 2024, answer questions nurse employers often have, and explain Nursys.com and Nursys e-Notify. Find additional details and instructions on how to participate here.

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.

2023-09-29T19:55:37+00:00September 29th, 2023|long-term care, Medicaid Eligibility Redetermination , Meetings and notices, Pennsylvania Bulletin|Comments Off on PA Health Policy Update for September 29
Read More

PA Health Policy Update for September 1

The following is an update of selected state health policy developments in Pennsylvania from August 28 – September 1.  (Some of the language used below is taken directly from state documents.)

Fiscal Year 2023-2024 Budget Update 

The state Senate convened for voting session Wednesday, August 30 and passed the remaining legislative piece of the Fiscal Year (FY) 2023-2024 budget – the Fiscal Code. House Bill 1300, which passed by a vote of 29-18, will now be sent to the House of Representative for consideration. A Fiscal Note outlining the provisions contained in the legislation can be found here. The Fiscal Code advanced by the Senate is not agreed to by House Democratic leaders and the House is currently not scheduled to return to Harrisburg until September 26. 

General Assembly

The House Commerce Committee will hold an informational hearing Wednesday, September 6 at 11:00am on HB 1201, which addresses consumer rights for the sharing of personal data by certain businesses and provides the Attorney General with enforcement authority. The legislation includes several exemptions from the provisions of the act including several health-related exclusions in compliance with HIPAA standards. The informational hearing will be held in Room 515 of the Irvis Office Building and will be livestreamed here.

The House Republican Policy Committee will hold a public hearing Thursday, September 7 at 10:00am on “Addressing the Mental Health Needs of Rural Communities.” The hearing will be held at the Pennsylvania College of Technology in Williamsport and will be live streamed here. 

Department of Human Services 

  • The Department of Human Services (DHS) has issued a Medical Assistance Bulletin advising providers of updates to the Medical Assistance (MA) program fee schedule as a result of the 2023 Healthcare Common Procedure Coding System (HCPCS) updates. DHS is also adding other procedure codes and making changes to procedure codes currently on the MA program fee schedule. These changes are effective for dates of service on and after September 5, 2023.
  • DHS has published Provider Quick Tip #268 to remind prescribers and providers that certain procedure codes and modifier combinations require prior authorization.
  • DHS has issued a Medical Assistance Bulletin with updates to the Family Planning Services program fee schedule, which are a result of the 2023 HCPCS updates.

Department of Health 

The Department of Health (DOH) has issued a Health Advisory (PAHAN – 716) regarding respiratory syncytial virus (RSV). The advisory provides important information about recommended monoclonal antibodies and recently approved vaccines for RSV. 

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

Pennsylvania Health Care Cost Containment Council – September 7

The Pennsylvania Health Care Cost Containment Council (PHC4) will hold a meeting at 10:00 a.m. on Thursday, September 7, 2023. The public is invited to participate. Contact rgreenawalt@phc4.org for participation instructions. 

DOH – HIV Community Prevention Planning Committee – September 20

The state-wide Human Immunodeficiency Virus (HIV) Community Prevention Planning Committee will hold a public meeting on Wednesday, September 20 from 3:00 to 7:00 p.m. The meeting will be held in person. Participants can also access the meeting virtually. Find additional details in this Pennsylvania Bulletin notice.

Patient Safety Authority – September 21

The Patient Safety Authority will hold a board meeting on Thursday, September 21 at 1:00 p.m. Find additional details and instructions on how to participate in this Pennsylvania Bulletin notice.

2023-09-05T13:44:35+00:00September 1st, 2023|Medicaid Eligibility Redetermination , Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance, Pennsylvania state budget issues|Comments Off on PA Health Policy Update for September 1
Read More

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
Read More

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
Read More

Home / About Us / Advocacy / Why Join? / SNAPShots / Contact Us

  • 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

Go to Top