PA Health Policy Update for January 31
The following is an update of selected state health policy developments in Pennsylvania January 27 – 31. (Some of the language used below is taken directly from state documents).
Governor Shapiro
Governor Shapiro will deliver his Fiscal Year (FY) 2025-2026 budget address to a joint session of the Pennsylvania General Assembly on Tuesday, February 4.
General Assembly
The state House of Representatives and Senate convened for voting session in Harrisburg this week. The following is an overview of selected health care-related legislative activity that occurred.
- The Senate Health & Human Services Committee met on Monday, January 27 and favorably reported Senate Bills 155, 156, and 157, which are part of a package of bills aimed at eliminating waste, fraud, and abuse in public assistance programs.
- The House Aging & Older Adult Services Committee convened for an informational meeting on direct care workers and the homecare industry. A recording of the meeting is viewable here.
- The House Insurance Committee met on Tuesday, January 28 and favorably reported, among other bills, House Bill 111, which prohibits insurers from denying coverage to individuals solely because they have an opioid reversal agent in their prescription profile. A recording of the meeting is viewable here.
- The House Human Services and Insurance Committees jointly convened on Wednesday, January 29 for an informational hearing on traumatic brain injury care needs and coverage options. A recording of the hearing is viewable here.
- The House Health Committee met on Wednesday, January 29 and favorably reported House Bill 27, which requires health care facilities to adopt and implement policies to mitigate exposure to surgical smoke through the use of a smoke evacuation system for each procedure that generates surgical smoke, and House Bill 33, which implements greater oversight of medical marijuana labs and product testing. A recording of the hearing is viewable here.
- The House Professional Licensure Committee met on Wednesday, January 29 and favorably reported House Bill 309, which enables team physicians traveling internationally with their club or national team to treat their team players on site during games without requiring a Pennsylvania medical license. A recording of the hearing is viewable here.
The state House of Representatives and Senate will convene for session in Harrisburg again next week. The chambers will hold a joint session on Tuesday, February 4 for Governor Shapiro’s FY 2025-2026 budget address.
Department of Human Services
The Department of Human Services (DHS) has issued an updated PA Promise™ Provider Handbook for providers who submit claims via the 837 Professional format or the CMS-1500 Claim Form.
DHS has shared the following presentations used at the Medical Assistance Advisory Committee (MAAC) meeting on January 23.
- Office of Developmental Programs (ODP)
- Office of Mental Health & Substance Abuse Services (OMHSAS)
- Office of Medical Assistance Programs (OMAP)
- Office of Long-Term Living (OLTL)
Health Department
The Shapiro administration, including the Department of Health (DOH) and the Department of Drug & Alcohol Programs (DDAP), highlighted its $3.6 million investment to develop regional maternal health coalitions. Find more information in this press release.
Around the State
- The Philadelphia Inquirer has published an article about Governor Shapiro’s plan to again propose the legalization of recreational marijuana in his budget address next week as a strategy to address the state’s growing budget shortfall.
- WESA has reported about the potential for a significant increase in premiums for Pennsylvanians enrolled in Pennie, the state’s health insurance marketplace, if federal tax credits are allowed to expire in 2026. The average premium increase would be 81 percent.
- Democratic lawmakers in Harrisburg introduced a package of bills this week seeking to codify protections provided by the Affordable Care Act (ACA) in Pennsylvania state law, as reported by the Pittsburgh Post-Gazette.
Stakeholder Meetings
DOH – Organ Donation Advisory Committee – February 6
The Organ Donation Advisory Committee will hold a public meeting on Thursday, February 6 from 10:00 a.m. to 1:30 p.m. The meeting will be held in person and virtually. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.
DOH – WIC State Advisory Board – February 11
The WIC State Advisory Board will hold its next regular meeting on February 11 from 11:00 a.m. to 12:00 p.m. This is a rescheduling of the board’s January 14 meeting, which was cancelled due to technical challenges. The meeting will be held in person and virtually. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.
DOH – Infant Hearing Screening Advisory Committee – February 13
The Infant Hearing Screening Advisory Committee will hold a public meeting on Thursday, February 13 from 10:00 a.m. to 12:00 p.m. The meeting will be held in person. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.
Patient Safety Authority – February 18
The Patient Safety Authority will hold a meeting of the Authority’s board on Tuesday, February 18 at 1:00 p.m. The meeting will be held virtually and is open to the public. Find additional details and information on how to participate in this Pennsylvania Bulletin notice.
During the PHE, the number of uninsured children in the state fell from 4.6 percent to 4.4 percent, but some of that improvement could be reversed as the state begins to redetermine the eligibility of more than 3.5 million people currently on the state’s Medicaid rolls after a more than two-year hiatus in eligibility reviews. Today, more than 1.4 million children in Pennsylvania are enrolled in Medicaid or CHIP.
Pennsylvania Act 2, passed earlier this year, appropriates $225 million in federal money and the state has earmarked a portion of that money for hospitals based on how many beds they have. Hospitals that serve especially high proportions of Medicaid patients, however, will receive funding over and above the amount targeted to them based on bed count alone.
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.
The 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.