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Archive for March 2013

Feds Offer New Carrot to Promote Medicaid Expansion

In their desire to persuade states to expand their Medicaid programs as called for in the Affordable Care Act, federal officials are now suggesting that states could use new federal Medicaid funds to enable Medicaid-eligible people to purchase private insurance. Even though this was not envisioned in the  health reform law, the prospect of making greater use of the private sector appears to be appealing to many Republican governors who have otherwise been reluctant to commit their states to expanding their Medicaid programs. Pennsylvania has no current plans to expand Medicaid eligibility, although there appears to be growing interest in doing so throughout the state.  Expansion would add approximately 500,000 people to the state’s Medicaid rolls, many of whom would … Read More

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

Immigrants Muddy Reform Calculus for Safety-Net Hospitals

Immigrants to the U.S. – legal and not – pose a special challenge in the health care environment of the future. Legal immigrants will not be able to benefit from many of the Affordable Care Act’s provisions until they have resided in the U.S. for five years while undocumented residents will not benefit from the reform law’s Medicaid expansion at all.  Meanwhile, many of these individuals will continue to turn to health care providers, and especially to hospitals, when they are sick or injured. But is this is a problem?  And if it is, how great a problem is it?  How many such individuals are there? The Robert Wood Johnson Foundation has attempted to answer that question in a new … Read More

Posted in Health care reform

MACPAC Reports to Congress

The Medicaid and CHIP Payment and Access Commission (MACPAC) has issued its March 2013 report to Congress. The agency, created to advise Congress on Medicaid and Children’s Health Insurance Program (CHIP) issues, offered two recommendations in its report. First, it recommended that Congress authorize states to implement 12-month eligibility for adults enrolled in Medicaid and children enrolled in CHIP, in much the same manner as they now do for children enrolled in Medicaid. And second, MACPAC urged Congress to fund permanently Transitional Medical Assistance (TMA), which enables families that become ineligible for Medicaid because they now earn more money than the program’s limit to retain their Medicaid eligibility for several additional months. The MACPAC report also includes analyses of several … Read More

Posted in Uncategorized

New Medicare Program Readmitted for Additional Work

Medicare’s new hospital readmissions reduction program has itself been readmitted for extra work after the federal government concluded that faulty calculations have resulted in inaccurate penalties and payments. The Centers for Medicare & Medicaid Services (CMS) has announced that as part of a recent reexamination of hospitals’ performance under the program, more than 1200 hospitals were overpenalized and more than 200 will have to pay larger penalties than they were originally assessed. The readmissions reduction program is being credited with a decrease in Medicare hospital readmissions across the country.  At the same time, however, a report in the New England Journal of Medicine suggested that the program will penalize hospitals that care for especially poor and sick patients.  MedPAC, the … Read More

Posted in Uncategorized

DSH Losses Will Hurt Safety-Net Hospitals

Safety-net and other hospitals will suffer financially when Affordable Care Act-mandated cuts in Medicare disproportionate share hospital payments (Medicare DSH) and Medicaid DSH payments begin taking effect in FY 2014. So concludes Moody’s, the bond-rating agency. The losses will be especially harmful to hospitals in states that do not expand their Medicaid programs and to safety-net hospitals, Moody’s believes. Currently, Pennsylvania has no plans to expand its Medicaid program as envisioned by the Affordable Care Act. Hospitals face other specific challenges as well as a result of these cuts. Read more about Moody’s assessment of the impact of future Medicare DSH and Medicaid DSH cuts in this report in Becker’s Hospital Review.

Posted in Health care reform

Hospitals Weigh Potential Impact of Medicaid Expansion in PA

Medicaid expansion in Pennsylvania could help compensate hospitals for the care they are currently providing to uninsured patients. And enhanced Medicaid payments made possible under the Affordable Care Act also could help hospitals with their Medicaid shortfalls:  the difference between what Pennsylvania pays hospitals for the Medicaid services they provide and the actual cost of those services. So hospital executives around the state recently told the Johnstown Tribune-Democrat. To learn more about how selected hospital executives view Medicaid expansion and why the Corbett administration has been reluctant so far to go ahead with that expansion, read the article “Small hospitals could gain from expansion” in this Johnstown Tribune-Democrat article.  

Posted in Health care reform, Pennsylvania Medicaid policy

Bill Would Create New Residency Positions

A new bill before Congress would create 15,000 new Medicare-sponsored medical residency spots – the first such new positions in 15 years. Half of those slots would be for physicians training for careers in primary care. The bill, which has bipartisan sponsorship, would cost between $9 billion and $10 billion over the next 10 years. Medical residents play a major role in caring for low-income and uninsured patients in many Pennsylvania safety-net hospitals. Read more about the possibility of new medical residency slots in this article from The Hill.

Posted in Uncategorized

New DPW Secretary Testifies Before Senate

Acting Department of Public Welfare Secretary Beverly Mackereth appeared before the Senate Appropriations Committee this week for the first time to present and defend her department’s proposed FY 2014 – including its Medicaid budget. Mackereth, herself a former member of the state House, also responded to committee members who questioned Governor Corbett’s decision not to expand Medicaid eligibility in the state, as provided for in the federal Affordable Care Act. She also promised more dialogue with the General Assembly in the future. Read more about Ms. Mackereth’s budget testimony before the Senate Appropriations Committee in this Allentown Morning Call article .

Posted in Pennsylvania Medicaid policy, Pennsylvania state budget issues, Proposed FY 2014 Pennsylvania state budget

Court Rules Against State in adultBasic Case

A Pennsylvania judge has concluded that the state violated its own constitution when it ended the adultBasic program without making other provisions to use tobacco settlement funds to help lower-income adults. The Corbett administration ended adultBasic in 2011 and used money previously designated for that program to support Pennsylvania’s Medicaid program.  Commonwealth Court judge Dan Pelligrini declared the laws that ended the program unconstitutional and said the state must use the money for adultBasic or a similar program. Learn more about the court decision, the circumstances surrounding the challenge to the end of adultBasic, and what might happen next in this York Daily Record article.

Posted in Uncategorized

State Mulls Shuttering Health Centers

Saying there are better ways to reach more people, Pennsylvania Department of Health officials are considering closing half of the state’s health centers, many of which serve rural parts of the state. The state would then focus on better ways of reaching people with public health services. Learn more about this potential policy initiative in this Harrisburg Patriot-News report .

Posted in Proposed FY 2014 Pennsylvania state budget
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2012 Safety-Net Association of Pennsylvania