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Archive for June 2012

Court Affirms Reform Law, Changes Medicaid Provision

The Supreme Court has upheld the constitutionality of the 2009 Affordable Care Act – including the much-disputed mandate that everyone obtain health insurance. The court’s only disagreement with the reform law was with its provision requiring states to expand Medicaid eligibility as a future condition of obtaining federal Medicaid matching funds.  The court ruled that expanding Medicaid eligibility should be optional and that states that choose not to expand their Medicaid programs would still receive the federal matching funds to which they have always been entitled. In the wake of this decision, SNAP is very concerned about the interplay between the loss of the mandated Medicaid expansion and the Affordable Care Act’s requirement that Medicare DSH and Medicaid DSH payments … Read More

Posted in Health care reform, Medicaid supplemental payments, Pennsylvania Medicaid policy

If the Affordable Care Act Survives Legal Challenges…

$2 billion in extra costs over the first five years.  750,000 new recipients. These are some of the changes that can be expected in Pennsylvania’s Medicaid program if the Medicaid expansion component of the Affordable Care Act is left standing after the Supreme Court rules on the legal challenge to the landmark health care reform legislation. The online publication PA Independent takes a look at the implications of Medicaid expansion for Pennsylvania:  implications for the state’s finances, for potential beneficiaries, and for public health.  Read the article here.

Posted in Health care reform, Pennsylvania Medicaid policy, Pennsylvania state budget issues

DPW Announces Fee Schedule Changes, More

The Department of Public Welfare (DPW) has announced changes in the Medical Assistance fee schedule and prior authorization requirements.  To read a notice describing these changes and find a list of affected procedure codes, see this notice in the Pennsylvania Bulletin.

Posted in Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy

PA to Discontinue Quality Incentive Program

The Pennsylvania Department of Public Welfare (DPW) is discontinuing its Hospital Quality Incentive Pilot Program.  The program had been “established to provide and reward a hospital’s performance on various quality related measures” in the state’s Medical Assistance program. Read a formal notice of the termination of this program, and the state’s Hospital Quality Care Investment Grant Program, in this Pennsylvania Bulletin notice.

Posted in Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy

DPW Publishes Bulletin Addressing Preventable Conditions

The Pennsylvania Department of Public Welfare (DPW) has posted a new Medical Assistance Bulletin presenting the state Medicaid program’s policies governing the reporting of “provider preventable conditions” effective July 1, 2012.  The policy applies to providers that serve Medical Assistance recipients enrolled in the fee-for-service and ACCESS Plus programs. Find the Bulletin here.

Posted in Meetings and notices, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy

Supreme Court Decision Has Huge Medicaid Implications

When the Supreme Court rules on the challenge to the Affordable Care Act, its decision will have enormous implications for states, low-income and uninsured people, and health care providers. Among the many features of the health care reform act on which the Supreme Court will rule is the single biggest expansion of eligibility since Medicaid was introduced in the mid-1960s. As they await the court’s decision, many states already are laying the groundwork for the addition of between 15 million and 20 million people to the nation’s Medicaid rolls. Pennsylvania’s safety-net hospitals have a considerable stake in the court’s decision because the planned Medicaid expansion could add as many as a half-million people to the state’s Medical Assistance rolls. The … Read More

Posted in Health care reform, Uncategorized

Safety-Net Hospitals Await Medicaid DSH Cuts

Across Pennsylvania, safety-net hospitals are bracing for major cuts in their Medicaid disproportionate share (DSH) payments starting in FY 2014, when a provision of the Affordable Care Act requiring such cuts takes effect. Under the Affordable Care Act, the number of uninsured patients hospitals treat is expected to decline as health insurance becomes more affordable and accessible, theoretically reducing hospitals’ need for Medicaid DSH revenue.  Under the reform law, federal spending on Medicaid DSH will be slashed $18 billion over six years. Historically, Medicaid DSH has been viewed as a program to help hospitals that treat especially large numbers of uninsured and Medicaid patients.  The cut will be implemented, however, before it is clear how many currently uninsured people will … Read More

Posted in Health care reform, Medicaid supplemental payments, Safety-Net Association of Pennsylvania

Newspaper Joins Call for Restoring Newborn Payments

Last month, Pennsylvania’s Medical Assistance program stopped paying hospitals for the inpatient care they provide to healthy babies newly born to Medical Assistance-covered mothers.  The hospital industry – including the Safety-Net Association of Pennsylvania (SNAP) – immediately expressed opposition to this new policy and has continued to seek the restoration of these payments as the state legislature considers Pennsylvania’s fiscal year 2013 budget. Now, the Pittsburgh Post-Gazette has weighed in on this issue – on the side of the hospital industry and the low-income patients it serves – with an editorial entitled “Dropping the baby:  DPW is wrong to cut newborns’ hospital care.”  Read that editorial here.

Posted in Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania state budget issues, Safety-Net Association of Pennsylvania

Forum on Safety-Net Hospitals

Health care reform presents a number of challenges to safety-net hospitals.  Recently, the Alliance for Health Reform and the Commonwealth Fund hosted a forum, “The Health of Safety-Net Hospitals:  How are They Faring?  What’s the Outlook?” to discuss these challenges. Among the issues addressed in the forum were the financial challenges safety-net hospitals face in the coming years as a result of health care reform and implementation of the Affordable Care Act; the response of safety-net hospitals to these challenges; the special challenges safety-net hospitals face as a result of social, economic, and environmental conditions in the communities they serve; and proposed changes in some of the payments safety-net hospitals have long counted upon to help underwrite the care they … Read More

Posted in Health care reform, Safety-Net Association of Pennsylvania

News from the Pennsylvania Health Law Project

The Pennsylvania Health Law Project has issued its May 2012 newsletter.  Included in it are articles on the expanded use of HealthChoices in the Medical Assistance program; information about proposed changes in the Medical Assistance Transportation Program; an update on limits on Medicaid recipients’ use of prescription drugs; the removal of children from the state’s Medicaid rolls; and the 2013 increase in Medicaid payments for primary care providers. Download the May edition of Health Law PA News, the newsletter of the Pennsylvania Health Law Project, here.

Posted in Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy
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2012 Safety-Net Association of Pennsylvania