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Archive for June 2014

Keep Medicaid Pay Boost, Docs Ask Congress

Physician groups and other health care organizations are asking Congress to continue the increase in Medicaid payments that primary care providers have been receiving for nearly two years. The pay raise, mandated by the Affordable Care Act, was instituted to help induce more primary care providers to serve Medicaid patients in anticipation of the reform law’s significant expansion of Medicaid eligibility.  That pay raise, which brings Medicaid rates up to the level of Medicare rates and is paid for entirely by the federal government, expires at the end of 2014. Now, primary care physicians have written to the leaders of the Senate Finance Committee and the House Energy and Commerce Committee asking them to extend the raises and add ob/gyns … Read More

Posted in Affordable Care Act, Pennsylvania Medicaid policy

SNAP Warns of Challenges Ahead

As Pennsylvania lawmakers contemplate the state’s FY 2015 budget, the Safety-Net Association of Pennsylvania has issued a new position paper reminding those officials of the challenges the state’s private safety-net hospitals face in the current environment and the need for adequate, stable funding as they tackle those challenges. Among those challenges are low-income patients with distinct needs, major cuts in federal Medicare payments that especially target safety-net hospitals, and powerful economic forces marshaled by government, insurers, and others that seek to compel hospitals to deliver care in different ways, be paid differently for their efforts, align their incentives differently with other providers, and invest heavily in information technology. Pennsylvania’s safety-net hospitals are prepared to do all these things, but to … Read More

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

Protect Uncompensated Care Payments, SNAP Tells State Officials

Although only 25 percent of the state’s acute-care hospitals, Pennsylvania’s private safety-net hospitals account for 45 percent of the $1 billion in uncompensated care those hospitals provide to uninsured Pennsylvanians every year. And now, as the governor and legislature consider the state’s FY 2015 budget, the Safety-Net Association of Pennsylvania is urging those officials to preserve state payments that help qualified hospitals with those uncompensated care costs and enable them to continue constituting the core of Pennsylvania’s health care safety net. Tobacco Uncompensated Care Fund payments are supplemental state payments to hospitals that provide significant amounts of uncompensated care; they are underwritten by proceeds from the national master tobacco settlement of 1998 and matched by the federal government.  As lawmakers … Read More

Posted in Pennsylvania Medicaid policy, Pennsylvania state budget issues

PA Safety-Net Hospitals Mean Jobs

While providing most of the care to Pennsylvania’s Medicaid and uninsured populations, the state’s 41 private safety-net hospitals also employ more people than other hospitals and pay better wages than most employers. They also are among the biggest employers in their communities, drive local economic development, and generate millions in local and state tax revenue. As state lawmakers consider Pennsylvania’s FY 2015 budget, the Safety-Net Association of Pennsylvania urges them to preserve adequate funding for the state’s Medicaid program so these hospitals can continue their work serving Pennsylvanians in need and functioning as one of the state’s major economic engines. Read more about the outsized role private safety-net hospitals play in Pennsylvania’s health care safety net and its economy in … Read More

Posted in Pennsylvania state budget issues, Safety-Net Association of Pennsylvania

340B Program Under the Microscope

Federal officials continue to cast a wary eye on a program that gives discounts on prescription drugs to hospitals that care for large numbers of low-income patients. The federal 340B Prescription Drug Program requires drug manufacturers to give discounts to eligible providers for the prescriptions they provide patients on an outpatient basis; the hospitals then provide their low-income patients with their prescriptions at a discount or free of charge.  The program has grown a great deal in recent years and now, critics argue that some hospitals that currently receive the discounts should not qualify for them and others are not reinvesting the savings the program generates in care for low-income patients. Hospitals, meanwhile, note that program savings enable them to … Read More

Posted in Uncategorized

Corbett Administration Announces Healthy PA MCOs

While the federal government has not yet announced whether it will approve the Corbett administration’s “Healthy Pennsylvania” Medicaid expansion plan, the administration continues to plan in anticipation of the proposal’s approval. In May, the administration published a Request for Applications (RFA) from managed care organization interested in serving the state’s Medicaid expansion population through a private, market-driven approach to Medicaid expansion. Now, the administration has announced that it has approved nine insurers as potential participants and will begin negotiating with those insurers. Learn more about this latest action, including the criteria for qualifying to participate and a list of the selected insurers in the nine regions the state has established for Healthy Pennsylvania Medicaid expansion, in this news release from … Read More

Posted in Affordable Care Act, Healthy PA, Pennsylvania Medicaid policy

SNAP Speaks Out on PA Budget Issues

In a series of three new position papers, the Safety-Net Association has laid out the case for why Pennsylvania needs to fund its Medicaid program adequately in the state’s upcoming 2015 fiscal year. The first paper, “Pennsylvania Safety-Net Hospitals:  Economic Engines Driving Pennsylvania Communities,” documents the degree to which safety-net hospitals not only provide significant numbers of jobs but also offer higher wages than other hospitals and other Pennsylvania employers. The second paper, “The Importance of Preserving Uncompensated Care Payments,” notes that Pennsylvania’s safety-net hospitals, just 25 percent of the state’s acute-care hospitals, provide nearly 50 percent of the $1 billion worth of uncompensated care hospitals in the state provide every year.  The state helps underwrite some of those costs … Read More

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

Stop Hurting Hospitals That Serve the Poor, HHS Told

Medicare’s hospital readmissions reduction program is unfairly penalizing hospitals that serve especially large numbers of low-income patients, 34 members of Congress have written in a letter to recently appointed Health and Human Services Secretary Sylvia Mathews Burwell and Centers for Medicare & Medicaid Services (CMS) administrator Marilyn Tavenner. The letter, sponsored by Rep. James Renacci (R-Ohio), notes that while the program has …incentivized hospitals to reduce readmissions, there are some factors outside of a hospital’s control that make it difficult for the patient to avoid readmission.  The current penalty methodology…has created an unintended consequence for hospitals that service our most vulnerable populations – dual-eligible beneficiaries; low-income seniors, or people with disabilities that are eligible for both Medicare and Medicaid. The … Read More

Posted in Uncategorized

Late Budget for PA?

Pennsylvania’s constitution calls for the state to adopt a budget for the next fiscal year by June 30, the end of its fiscal year, but it is looking more and more as if the legislature and governor will miss that deadline this year. Although budgets typically come easily when the same party controls the governor’s mansion and both chambers of the General Assembly, the state’s revenue shortfall, a structural deficit that will carry over into next year, and the introduction of additional issues into the budget process appear to be slowing progress toward adopting a spending plan for the state’s 2015 fiscal year. To reinforce the notion that June 30 may come and go without a budget adopted, state Senate … Read More

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

MedPAC: Keep Paying More For Medicare Primary Care Services

The federal government should continue paying extra for primary care services provided to Medicare patients, Congress has been told by its chief advisor on Medicare payment policy. According to the Medicare Payment Advisory Commission (MedPAC), the independent federal agency that advises Congress on Medicare payment matters, Medicare has long undervalued primary care services in comparison to specialty medical care, and in 2010 the Affordable Care Act introduced a ten percent bonus for primary care services provided to seniors through 2015. With the expiration of that bonus coming in a little more than a year, MedPAC has told Congress it should seek to continue the practice but perhaps by making the additional payment on a per beneficiary basis rather than a … Read More

Posted in Affordable Care Act
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2012 Safety-Net Association of Pennsylvania