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PA Health Policy Update for August 11

The following is an update of selected state health policy developments in Pennsylvania from August 7 – 11. (Some of the language used below is taken directly from state documents.)

General Assembly

The House Professional Licensure Committee held a public hearing Monday, August 7 on HB 1000, which seeks to provide prescription authority to psychologists who complete specialized training. A recording of the hearing can be viewed here.

Department of Human Services

The Department of Human Services (DHS) has issued Provider Quick Tip #263 with updated information regarding the electronic submission process for Office of Medical Assistance Fee-for-Service (FFS), Office of Long-Term Living (OLTL), and long-term care 180-day exception requests requiring documentation.

The Office of Mental Health & Substance Abuse Services (OMHSAS) has reminded stakeholders that its application is still open for qualified entities to request funding to invest in technology and training for behavioral health telehealth providers. Organizations with 51 or more employees are ineligible. The application deadline is December 31, 2023. Learn more about this funding opportunity here.

Department of Health

The Department of Health (DOH) and the Department of Drug and Alcohol Programs (DDAP) have requested that organizations who plan to request fentanyl and xylazine test strips complete “pre-order” information here. DOH, DDAP, and the Commission on Crime and Delinquency are working to establish a new program that can provide organizations with a supply of test strips at no cost. Organizations that make a request through the pre-order form will be contacted when orders can be filled.

DOH has issued a Health Advisory (PAHAN – 714) notifying clinicians of recently identified variant influenza viruses (A H1N2v and A H3v) in the U.S. The advisory also contains diagnosis and reporting guidance for clinicians.

Department of Aging

The Department of Aging has announced the state’s 52 Area Agencies on Aging (AAAs) will be hosting in-person listening sessions in all 67 counties to gather input on Pennsylvania’s Master Plan for Older Adults – a 10-year strategic plan designed to transform infrastructure and coordination of services for older Pennsylvanians.

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.

PA Safety Net Admin2023-08-11T18:45:22+00:00August 11th, 2023|long-term care, Medicaid Eligibility Redetermination , Pennsylvania Medicaid|Comments Off

End of PHE Could Cut Kids From PA Medicaid Rolls

When the formal COVID-19 public health emergency ends, as many as one out of every four Pennsylvania children enrolled in Medicaid could lose their state-sponsored health insurance, according to new research by the Pennsylvania Partnership for Children.

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.

Even with the PHE-inspired improvements, 5.5 percent of children in the state who qualify for some kind of free or subsidized health insurance remain uninsured, according to the research.

Uninsured children, like the uninsured population at large, are far more likely than not to be treated by Pennsylvania’s safety-net hospitals such as those that belong to the Safety-Net Association of Pennsylvania (SNAP). As a result, any reduction in the rate of uninsured children would have a correspondingly damaging effect on the financial health of those safety-net hospitals – and potentially, on the residents of the medically vulnerable communities those hospitals serve.

Learn more about how the end of the PHE may affect health care coverage for Pennsylvania children in the Pennsylvania Capital-Star article “Report: Ranks of uninsured Pa. kids dropped during pandemic.”

jsteinbock2022-12-14T15:26:58+00:00December 14th, 2022|COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus|Comments Off

SNAP Hospitals Benefit From New PA Health Care Funding

While a recent Pennsylvania law will result in all hospitals receiving supplemental funding to help with employee recruitment and retention, SNAP member hospitals will receive a little something extra.

Safety-Net Association of Pennsylvania logo 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.

All Safety-Net Association of Pennsylvania members – hospitals distinguished by their service to especially large numbers of low-income Pennsylvanians – will receive a portion of these additional resources.

All hospitals and other selected providers will share $100 million of the $225 million total; this portion will be distributed on a per-bed basis. Pennsylvania safety-net hospitals, along with critical access hospitals and inpatient and residential behavioral health facilities, also will receive part of a separate, larger pool of $110 million.

Over the years, SNAP has consistently urged state officials to provide additional funding to Pennsylvania safety-net hospitals that care for especially high proportions of Medicaid and uninsured patients. In this situation, state officials did exactly that.

Learn more about the $225 million appropriation and how it will be distributed from this Wolf administration news release and this list of funding recipients, which includes all SNAP members.

jsteinbock2022-03-25T13:10:50+00:00March 25th, 2022|Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

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.

jsteinbock2021-06-15T17:52:15+00:00June 15th, 2021|340b, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

Change Atop PA’s Department of Human Services

Teresa Miller is out and Meg Snead will be in as Pennsylvania’s new Secretary of the Department of Human Services.

In separate news releases the Wolf administration announced that Miller, who has led DHS since 2015, “will be moving on to a new opportunity outside Pennsylvania” and leave her job at the end of April and that she will be replaced by Meg Snead, who currently serves as the governor’s Secretary of Policy and Planning.

Snead’s nomination is subject to confirmation by the state Senate.

The Secretary of the Department of Human Services is important to SNAP members and Pennsylvania safety-net hospitals because the state’s Medicaid program is administered by that department’s Office of Medical Assistance Programs.

Learn more about Miller’s departure here and about Snead’s nomination here.

PA Safety Net Admin2021-03-25T06:00:37+00:00March 25th, 2021|Pennsylvania Medicaid, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania|Comments Off

House to Consider Extending Medicare Sequester Delay

The moratorium on the two percent sequestration of Medicare payments could be extended under a bill the U.S. House of Representatives may consider this week.

If adopted, the bill would extend the sequester delay for nine months, providing financial relief that many health care providers seek as they continue to deal with the financial challenges posed by COVID-19.

The sequester delay was implemented early in the pandemic as a means of providing additional Medicare revenue to hospitals and other health care providers at a time when many people were delaying seeking medical attention out of fear of contracting COVID-19.

Without action by Congress, the current delay of the Medicare sequester will expire at the end of March.

Safety-Net Association of Pennsylvania logo SNAP has urged Congress to extend the Medicare sequestration delay on a number of occasions, doing so most recently in this February 5 letter to members of Pennsylvania’s congressional delegation.

Learn more about the latest effort to extend the Medicare sequester delay in the Fierce Healthcare article “House to vote later this week on bill to delay Medicare sequestration payment cuts.”

PA Safety Net Admin2021-03-18T06:00:32+00:00March 18th, 2021|Medicare, Safety-Net Association of Pennsylvania|Comments Off

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 logo 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.

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.

PA Safety Net Admin2021-02-05T17:20:29+00:00February 5th, 2021|Coronavirus, COVID-19, Federal Medicaid issues, Medicare|Comments Off

SNAP Asks Congress to Help Hospitals Keep Provider Relief Fund Grants

Pennsylvania’s safety-net hospitals could lose some or all of their CARES Act Provider Relief Fund grant money and the Safety-Net Association of Pennsylvania is asking members of the state’s congressional delegation to intervene on their behalf to prevent it.

Safety-Net Association of Pennsylvania logo At issue are financial reporting requirements that at first directed hospitals to estimate their anticipated revenue losses and extra expenses associated with the COVID-19 pandemic in one way and then shifted to a new approach. The first grant distribution was based on the original reporting requirements, and now, hospitals fear that the change in reporting requirements could leave them vulnerable to a demand that they return some, much, or all of that grant money.

The Department of Health and Human Services announced one set of reporting requirement in June and then proposed modifying them in September. In response to widespread expressions of concern, including from SNAP, HHS revised those proposed changes – but not enough, according to many stakeholders, leaving them concerned that HHS would ask them to return some of their grant money. Now, SNAP is asking the same members of the Pennsylvania congressional delegation who asked HHS to reconsider the reporting requirements to do so again.

See SNAP’s letter to the delegation asking its members to sign onto a bipartisan letter asking HHS to revise its reporting requirements once again. Go here to see the letter members of Congress are being asked to sign.

PA Safety Net Admin2020-12-14T10:20:08+00:00December 14th, 2020|Coronavirus, COVID-19|Comments Off

SNAP Asks PA Delegation for COVID-19 Aid

SNAP has written to Pennsylvania’s congressional delegation to request additional COVID-19 legislation between now and the end of the year to help Pennsylvania safety-net hospitals respond to the health care and financial challenges posed by the pandemic.

In its letter, SNAP asked Congress for:

additional funding for the Provider Relief Fund for assistance to hospitals;
extension of the temporary moratorium on continued implementation of the 2011 Budget Control Act’s Medicare sequestration; and
the suspension of any other federal cuts for health care providers, such as the scheduled reduction of Medicaid disproportionate share (Medicaid DSH) allocations to the states.

Read SNAP’s message to Congress.

PA Safety Net Admin2020-12-08T06:00:24+00:00December 8th, 2020|Coronavirus, COVID-19, DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania Medicaid, Pennsylvania safety-net hospitals|Comments Off

COVID-19 Update: Friday, December 4

The following is the latest COVID-19 information from the state and federal governments as of 2:45 p.m. on Friday, December 4.

SNAP Advocacy

Safety-Net Association of Pennsylvania logo SNAP has written to Congress to request additional COVID-19 legislation between now and the end of the year. SNAP asked Congress for additional funding for the Provider Relief Fund; extension of the temporary moratorium on continued implementation of the 2011 Budget Control Act’s Medicare sequestration; and the suspension of any other federal cuts for health care providers, such as the scheduled reduction of Medicaid disproportionate share (Medicaid DSH) allocations to the states. Read SNAP’s message to Congress.

Pennsylvania Update

Department of Health

The Department of Health has posted a fact sheet on the CDC’s arrangement with pharmacies to provide on-site COVID-19 vaccination services for residents of nursing homes and assisted living facilities once vaccination is recommended for them.
The Department of Health has compiled answers to frequently asked questions about the Secretary’s order for the reduction of elective procedures in regions that meet certain COVID-19-related metrics. The department also updated its COVID-19 guidance to hospitals to incorporate changes made by the elective procedures order.
The Department of Health shared clarification it received from CMS explaining that personnel providing non-emergency medical transportation under arrangements with nursing facilities should be tested for COVID-19 or required to prove that testing was completed elsewhere during the time frame that corresponds with the facility’s testing frequency. This requirement does not apply to individuals providing emergency services.
The Department of Health issued a health alert with updated quarantine recommendations for persons in the community exposed to COVID-19. This alert does not apply to staff working in health care settings who are exposed to COVID-19, who should follow guidance outlined in PA-HAN-510, or to patients and residents in health care settings, who should follow PA-HAN-526.
The Department of Health shared on its message board the following information to clarify that surveyors visiting licensed facilities are required to follow the department’s own testing and visitation protocols:

The Department of Health recognizes the need to protect the patients and residents in healthcare facilities by ensuring that visitors (including Department of Health employees) follow guidance and requirements issued by the Department of Health and CMS regarding visitation to healthcare facilities. Surveyors from the Department of Health are required to follow these requirements and guidance. The Department of Health also has its own testing program for our surveyors. Because of HIPPA we cannot share medical results of our employees, but again we can assure you that all employees who are on site at facilities are compliant with all Department of Health and CMS guidance and requirements.

Department of Health – by the numbers

For the second consecutive day, Pennsylvania set a new high for new COVID-19 cases in a single day.
More than 11,000 Pennsylvanians have now died from COVID-19. Daily death figures are now the highest they have been since the pandemic began.
Nearly 38,000 residents of long-term-care facilities and more than 7100 people who work in those facilities have contracted COVID-19. Those figures encompass 1316 facilities in 65 of Pennsylvania’s 67 counties.
More than 15,000 health care workers in the state have contracted COVID-19.
More than 1000 Pennsylvanians are currently in hospital intensive care units being treated for COVID-19.
Nearly 600 Pennsylvanians are currently breathing with the help of a ventilator because they have COVID-19.
16 percent of hospital adult ICU beds are currently unoccupied, as are 15 percent of medical/surgical beds, 40 percent of pediatric beds, 17 percent of pediatric ICU beds, and 34 percent of airborne isolation unit beds.

Around the State

The Pittsburgh Tribune-Review reports that “More than one-third of hospitals in Southwestern Pennsylvania anticipate staffing shortages in the coming week.”
It also notes that “In Allegheny County, just over 11% of adult ICU beds in the county remain available – about 91 beds in total.”
ICU beds are a major concern, the Tribune-Review adds, explaining that “Intensive care units already are at capacity in two Western Pennsylvania hospitals. Officials with Butler Health System said in a release Wednesday units at Butler Memorial and Clarion hospitals are full, and the health system has activated phase one of its surge plan.”
That plan “…includes converting Butler Memorial’s post-anesthesia care unit into an intensive care unit, which will add 15 more critical care beds in the hospital.”
In addition, the Tribune-Review adds, “The health system will suspend all nonemergency elective surgeries and procedures that would require an in-patient stay, a move officials hope will free up as many beds as possible.”
In addition, the Pittsburgh Business Times reports that the state’s Keystone region also is expected to see staffing shortages in the coming week. That region consists of Adams, Bedford, Blair, Centre, Cumberland, Dauphin, Franklin, Fulton, Huntingdon, Juniata, Lancaster, Lebanon, Mifflin, Perry, Snyder, and York counties.
The Harrisburg Patriot-News explains that “WellSpan York Hospital has put up a tent outside its emergency room and plans to add trailers. A spokesman said the space is for isolating ER patients awaiting results of COVID-19 tests. It’s not being used to house hospitalized patients, nor is the ER housing hospitalized patients.”
The Philadelphia Business Journal notes that on Wednesday, Philadelphia’s Health Department “…reported 859 patients with Covid are now being treated in city hospitals, nearing the 1,000 Covid admissions level Philadelphia medical centers experienced during the spring.”
Finally, the Philadelphia Inquirer reported that “The counties whose hospital ICUs were completely filled with coronavirus patients, according to state data, included Lycoming, Schuylkill, and Washington. Most have small capacities, with some having fewer than five or 10 ICU beds in total, according to state data.”

Department of Human Services

DHS’s Office of Developmental Programs has posted guidance to community and life-sharing home providers about how to apply updated COVID-19 testing guidance and infection control procedure guidance issued by the state’s Department of Health.

Federal Update

Centers for Medicare & Medicaid Services

CMS has updated its FAQs on Medicare fee-for-service billing with 14 new questions that address administration and billing for monoclonal antibody therapy. The new questions can be found on pages 33-34, p. 34, pp. 120-121, p. 121, pp. 121-124, pp. 124-125, p. 125 (four questions), p. 126, pp. 126-127, p. 127, and pp. 127-128.
CMS covers much the same ground in an updated version of its document “Medicare Monoclonal Antibody COVID-19 Infusion Program Instruction.”
CMS has published a statement on its intended use of its enforcement discretion on skilled nursing facility consolidated billing for COVID-19 vaccines and monoclonal antibody infusions. Through the exercise of this discretion, CMS will permit Medicare-enrolled immunizers to bill directly and receive direct reimbursement from the Medicare program. Go here to see the complete statement.

Coronavirus (COVID-19) Stakeholder Calls

CMS hosts recurring stakeholder engagement sessions to share information about the agency’s response to COVID-19. These sessions are open to members of the health care community and are intended to provide updates, share best practices among peers, and offer participants an opportunity to ask questions of CMS and other subject matter experts.

COVID-19 Office Hours Call

Tuesday, December 8 at 5:00 (eastern)

Toll Free Dial-In: 833-614-0820; Access Passcode: 3129517

Audio Webcast link: go here.

Tuesday, December 22 at 5:00 (eastern)

Toll Free Dial In: 833-614-0820; Access Passcode: 3968359

Audio Webcast link: go here.

Conference lines are limited so CMS encourages interested parties to join via audio webcast.

To listen to the audio files and read the transcripts for past stakeholder calls, go here.

Department of Health and Human Services

HHS has issued a fourth amendment to the Declaration under the Public Readiness and Emergency Preparedness Act (PREP Act) to increase access to critical countermeasures against COVID-19, including greater use of telehealth. Go here for a more detailed description of what the amendment authorizes.

Food and Drug Administration

On Tuesday, December 8 at noon (eastern) the FDA will host a webinar on its enforcement policy for sterilizers, disinfectant devices, and air purifiers during the COVID-19 pandemic as part of its series on respirators and other personal protective equipment for health care personnel use during the pandemic. Go here for further information about the webinar and how to participate.
The FDA has issued emergency use authorization for a bioburden-reduced N95 respirator. See the FDA’s letter of authorization and its fact sheet for health care providers.