Archive for May 2013
The chairman of the Pennsylvania House Appropriations Committee has introduced a bill proposing a budget for the state’s 2014 fiscal year. House Bill 1437, sponsored by Rep. Bill Adolph (R-Delaware), calls for $100 million less spending than the $28.4 billion budget proposed by Governor Tom Corbett in February. The bill also includes a number of differences in proposed spending for Medicaid and Department of Health programs. For a summary of the bill, with an emphasis on provisions with the greatest interest to Pennsylvania’s safety-net hospitals, please hit the “contact us” link at the top of this screen.
The Department of Public Welfare has unveiled its plan for increasing the fees it pays for Medicaid primary care services in 2013 and 2014. The limited-term pay increase, which will raise Medicaid primary care payments to Medicare levels, is mandated by the Affordable Care Act. A Pennsylvania Bulletin notice that addresses how and when the fee increases will be paid, and to whom they will be paid, can be found here. The revised fee schedule with the new, higher fees can be found here.
The Pennsylvania Department of Public Welfare has released a letter it sent to the state’s Independent Fiscal Office (IFO) rejecting many of the assumptions underlying the latter’s analysis of the cost of expanding Medicaid eligibility in the state and stating that as a result of these incorrect assumptions, the IFO has significantly understated the cost of Medicaid expansion in Pennsylvania. According to the letter sent by acting DPW secretary Beverly Mackereth to IFO director Matthew Knittel, the IFO inaccurately characterizes the baseline year during which to account for potential costs and savings; incorrectly maintains that upfront costs – including hiring 2000 new workers at higher salaries than the IFO projects – will be less than savings; and overstates savings associated … Read More
The Affordable Care Act-mandated fee increase for primary care physicians serving Medicaid patients is not reaching those physicians. Or so reports the Washington Post, which writes that only a few states are paying primary care providers more money to serve Medicaid patients. The pay raise is considered an important tool to help encourage more primary care providers to serve Medicaid patients at a time when Medicaid enrollment is expected to increase significantly because of the Affordable Care Act’s Medicaid expansion provisions. Under the health reform law, Medicaid payments for primary care services, traditionally very low, are to be raised to the same level as Medicare primary care payments for two years – calendar years 2013 and 2014. Five months into … Read More
Pennsylvania is asking the federal government to continue full funding of the health insurance program for hard-to-insure people created under the Affordable Care Act. PA Fair Care currently provides health insurance for 6900 Pennsylvanians with medical conditions that usually make health insurance too expensive for them to purchase. The federal government allocated $5 billion for the program, but even though nation-wide enrollment is less than one-third of what the Obama administration estimated, the program has expended most of its initial appropriation and the federal government has asked states to stop enrolling new members and shift existing members into the federal version of the program or risk liability for costs the federal government will no longer subsidize. Read more about PA … Read More
Even if Pennsylvania decides to go ahead and expand its Medicaid program, such expansion is unlikely before January of 2015, according to the state official who would be responsible for leading that expansion. State officials still have not decided whether the state will expand its program as envisioned under the Affordable Care Act, but even if they decide to expand, Department of Public Welfare acting secretary Beverly Mackereth has indicated that the work involved in such an undertaking makes it unlikely that expansion could begin until January of 2015. Currently, state officials are negotiating possible terms of expansion with the U.S. Department of Health and Human Services. A decision on expansion most likely depends on the outcome of those negotiations. … Read More
Cuts in Medicare DSH and Medicaid DSH payments, scheduled to be take effect beginning in FY 2014, would be delayed for two years under a new bill proposed in Congress. Under the DSH Reduction Relief Act of 2013, Affordable Care Act-mandated cuts in Medicare disproportionate share payments (Medicare DSH) and Medicaid disproportionate share payments (Medicaid DSH) would not begin until FY 2016, instead of in FY 2014, as the reform law requires. The bill was proposed by Representative John Lewis (D-GA). Read more about The DSH Reduction Relief Act in this article from Becker’s Hospital Review.
With many states preparing to expand their Medicaid programs and enroll unprecedented numbers of new people, it is not clear whether Medicaid coverage will lead to access to care. That concern arises in the wake of a survey that found that only 43 percent of physicians accept Medicaid patients. Other providers, moreover, may not be up to filling the gap: the same survey found that only 20 percent of physician assistants and nurse practitioners serve Medicaid patients. Thus, while more people than ever will have health insurance once the Medicaid expansion component of the Affordable Care Act takes effect, it is not clear whether those who find themselves newly insured will have reasonable access to medical services. While the Affordable … Read More
Since January of last year, Pennsylvania’s Medical Assistance program has limited categorically needy adult recipients over the age of 21 to six prescriptions a month. While Medical Assistance has established a process for seeking exceptions to this limit, the Department of Public Welfare has now published a new MA Bulletin that lists exceptions that will automatically be granted. Find that list in this MA Bulletin.
In a letter to the leaders of the two legislative appropriations committees, Pennsylvania Department of Public Welfare Acting Secretary Beverly Mackereth has questioned whether the state can rely on the continued availability of certain key parts of funding Medicaid expansion in the commonwealth. In particular, Secretary Mackereth questioned whether Pennsylvania would be able to continue levying its gross receipts tax on managed care organizations, which is expected to produce $1.5 billion in revenue to use for Medicaid over the next seven years. Pennsylvania also has a number of potential Medicaid deferrals and allowances under consideration by the federal government that could result in the state receiving less federal Medicaid matching money. Read Secretary Mackereth’s letter to legislative leaders, and a … Read More