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SNAP Asks PA Delegation to Co-Sponsor, Support 340B Bill

SNAP has asked members of Pennsylvania’s congressional delegation to co-sponsor and support bills (H.R. 3203 and S. 773) that would temporarily enable Pennsylvania safety-net hospitals and others already eligible for the 340B prescription drug discount program to remain eligible for the program despite short-term changes in their admissions patterns brought about by the COVID-19 pandemic.

Because of the manner in which the COVID-19 pandemic affected hospital admissions, some hospitals that have been eligible to participate in the 340B program could lose that eligibility for what is, in effect, a one-year anomaly.  The proposed bills would temporarily enable current 340B participants to retain their eligibility for the program until hospitals’ inpatient volume returns to normal and they can demonstrate whether they still meet the criteria to continue participating in the program.

340B has long been a vital tool through which Pennsylvania safety-net hospitals receive significant discounts on the prescription drugs their low-income patients need, enabling these hospitals and other eligible providers to stretch scarce resources in services to the communities that depend on them.

Learn more from SNAP’s letter to members of Pennsylvania’s congressional delegation.

2021-06-15T17:52:15+00:00June 15th, 2021|340b, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off on SNAP Asks PA Delegation to Co-Sponsor, Support 340B Bill

SNAP Asks PA Delegation for Help From COVID-19 Relief Bill

The next federal COVID-19 relief bill should include more resources for the Provider Relief Fund, SNAP has told members of Pennsylvania’s congressional delegation.

Safety-Net Association of Pennsylvania logoThe bill also should include additional targeted funding for safety-net hospitals, help with staffing, an extension of the current moratorium on the Medicare sequestration, and forgiveness for safety-net hospitals for loans they received under the Medicare Accelerated and Advance Payment Program.

This was the message the Safety-Net Association of Pennsylvania conveyed last week in a letter to members of Pennsylvania’s congressional delegation.  See that letter here.

2021-02-05T17:20:29+00:00February 5th, 2021|Coronavirus, COVID-19, Federal Medicaid issues, Medicare|Comments Off on SNAP Asks PA Delegation for Help From COVID-19 Relief Bill

Congress Gives Hospitals Medicaid DSH Relief

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

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

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

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

2020-10-08T13:00:02+00:00October 8th, 2020|Federal Medicaid issues, Medicaid supplemental payments|Comments Off on Congress Gives Hospitals Medicaid DSH Relief

Payer Mix to Change, Providers Anticipate

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

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

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

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

2020-10-05T06:00:21+00:00October 5th, 2020|Pennsylvania safety-net hospitals|Comments Off on Payer Mix to Change, Providers Anticipate

MACPAC Meets

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

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

The February 2020 MACPAC meeting opened with a continuation of MACPAC’s examination of Medicaid’s role in maternal health, when Medicaid officials from Michigan, New Jersey, and North Carolina joined the Commission to discuss how their states are addressing maternal morbidity and mortality.* The Commission plans to include a chapter on maternal health in its June 2020 report to Congress. Commissioners later turned their attention to policy options for improving enrollment in the Medicare Savings Program.

The Commission later took a deep dive into value-based payment in Medicaid managed care. This three-part session began with findings from a series of interviews with state officials, managed care organizations, and other stakeholders aimed at understanding how states use managed care to promote payment reform, conducted by MACPAC contractor Bailit Health. Then, representatives from three of these organizations shared their reactions to the findings and talked about how value-based payment models are working in practice.* The session concluded with Commissioners’ perspectives on the study’s findings and the panelists’ reactions to them, and possible next steps.

The final session of the afternoon continued a line of inquiry begun at the October 2019 meeting: third-party liability coordination between Medicaid and TRICARE. MACPAC estimates that almost 1 million Medicaid enrollees have primary coverage through TRICARE, which provides health benefits for military personnel, military retirees, and their dependents. Commissioners explored making recommendations in the June report to improve coordination between the two programs.

On Friday, the Commission returned to the theme of improving care for dually eligible beneficiaries, looking more closely at the rise of so-called dual-eligible special needs plan (D-SNP) look-alikes and how changes in the Medicare Advantage market are affecting efforts to integrate care. Commissioners also reviewed a rule proposed in February that would, among other things, restrict the growth of look-alikes.

Following that session, the Commission discussed draft recommendations to improve integration of Medicare and Medicaid benefits for dually eligible beneficiaries. The February meeting wrapped up with a discussion of a forthcoming rule expected to affect the Medicaid eligibility determination process.

Supporting the discussion were the following briefing papers:

  1. State Medicaid Initiatives to Improve Maternal Health
  2. Improving Participation in the Medicare Savings Programs: Decisions on Draft Recommendations for the June Report to Congress
  3. State Strategies to Promote the Use of Value-Based Payments in Medicaid Managed Care
  4. Medicaid and TRICARE: Third-Party Liability Coordination
  5. How Changes in the Medicare Advantage Market Are Affecting Integration of Care for Dually Eligible Beneficiaries: Analysis and Comments on Proposed Rule
  6. Improving Integrated Care for Dually Eligible Beneficiaries: Decisions on Recommendations to be Included in June Report to Congress
  7. Forthcoming Rule on Program Integrity and Eligibility Determination Processes

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

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

2020-03-06T06:00:04+00:00March 6th, 2020|Federal Medicaid issues, Pennsylvania safety-net hospitals|Comments Off on MACPAC Meets

New Poverty Level Standards to Jeopardize Medicaid Eligibility?

The Trump administration is considering changing how the federal government measures inflation for the purpose of calculating the federal poverty level.

Such a change, if implemented, could potentially reduce inflation-related increases in the federal poverty level, which in turn could limit the ability of some individuals and families to qualify, or continue to qualify, for a variety of public safety-net services – including, potentially, Medicaid.

Among the possible alternatives to the current methodology for calculating inflation is the Chained Consumer Price Index for All Urban Consumers.  The Obama administration also explored substituting this index for the current inflation factor.

Any change that makes it more difficult for people to qualify for Medicaid could be particularly damaging to Pennsylvania safety-net hospitals, which are generally located in communities with especially large numbers of low-income residents.  If patients lose their Medicaid eligibility because the criteria for participating in the program change, that could leave such hospitals serving even more uninsured patients and providing even more uncompensated care than they already do.

The federal Office of Management and Budget has issued a request for comment about various inflation factor calculation alternatives.  Go here to see OMB notice Request for Comment on the Consumer Inflation Measures Produced by Federal Statistical Agencies.  Comments are due in late June.  Learn more from the New York Times article  “Trump Administration Seeks to Redefine Formula for Calculating Poverty.”

2019-05-10T06:00:54+00:00May 10th, 2019|Federal Medicaid issues, Pennsylvania safety-net hospitals|Comments Off on New Poverty Level Standards to Jeopardize Medicaid Eligibility?
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