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Archive for August 2014

PA Medicaid Expansion Approved by Feds

Pennsylvania’s request for federal approval of its Medicaid expansion plan has been approved by the federal government. The plan, part of the Corbett administration’s “Healthy Pennsylvania” health care reform proposal, calls for an expanded population of Pennsylvanians who are newly eligible for Medicaid to obtain subsidized coverage through the private health insurance market – managed care organizations approved by the state to serve the new Medicaid expansion population. The letter of approval from Centers for Medicare & Medicaid Services (CMS) administrator Marilyn Tavenner to Pennsylvania Department of Public Welfare Secretary Beverly Mackereth notes that …the state aims to modify Pennsylvania’s Medicaid program and expand access to coverage to adults in Pennsylvania with incomes through 133 percent of the federal poverty … Read More

Posted in Affordable Care Act, Health care reform, Healthy PA, Pennsylvania Medicaid policy

Charity Care? Wait a Minute

Many hospitals are considering whether they should continue to provide charity care to people who were eligible for Affordable Care Act subsidies to purchase health insurance but chose instead to remain uninsured. The issue for many is whether the availability of charity care is an inducement for some people not to purchase health insurance and whether such patients are unwilling or unable to pay for care. Some hospitals have decided not to provide non-emergency charity care to those who chose not to purchase subsidized health insurance.  Others are currently considering whether they need to revise their approach to charity care.  Still others have decided that they will not change their charity care policies. Charity care is an especially critical issue … Read More

Posted in Affordable Care Act

PA Introduces New ER Pain Treatment Guidelines

The Pennsylvania Department of Health and Department of Drug and Alcohol Programs have released new guidelines for the treatment of pain in hospital emergency rooms. The guidelines, proposed by the Safe and Effective Prescribing Practices and Pain Management Task Force, were developed by the Pennsylvania College of Emergency Physicians and presented by a task force that included representatives of government, health care professions, and associations. See a state news release about the guidelines here and download the guidelines themselves here.

Posted in Uncategorized

Clock Ticking for 12,600 Newly Insured Pennsylvanians

12,600 Pennsylvanians newly insured through the Affordable Care Act will lose their health insurance at the end of September if they cannot prove their eligibility for that insurance. Most of these cases involve questions about whether the newly insured are living in the U.S. legally. These 12,600 Pennsylvanians are among approximately 300 ,000 people nation-wide whose eligibility for insurance and insurance subsidies is currently under review by the federal government and who have not yet responded to requests for information about citizenship, immigration status, or income. The affected people have until September 5 to provide the requested information.  Those who fail to do so, and those who do not meet the requirements, will lose their health insurance as of September … Read More

Posted in Uncategorized

Readmissions and Quality: Are They Related?

A new study casts doubt on a major principle underlying a good deal of recent federal health care policy. That principle holds that hospitals that have lower rates of 30-day readmissions of Medicare patients provide better, more economical care than those with higher readmission rates. But that may not be true. According to an examination of the performance of safety-net hospitals in California published in the journal Health Affairs, those safety-net hospitals are more likely than others to be penalized by Medicare’s hospital readmissions reduction and value-based purchasing programs. At the same time, however, these same hospitals had lower 30-day, risk-adjusted mortality rates for patients treated for myocardial infarction, heart failure, and pneumonia.  The safety-net hospitals also had marginally lower … Read More

Posted in Affordable Care Act, Health care reform

New Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its latest newsletter. Among the articles are stories about the preservation of the state’s Medical Assistance for Workers with Disabilities Program (MAWD); new funding for home- and community-based services for people with disabilities; a clarification of Children’s Health Insurance Program (CHIP) benefits; and more. Find the newsletter here.

Posted in Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy

Translating Insurance Into Care

While the Affordable Care Act is enabling millions of Americans to obtain health insurance – many of them for the first time – many of the newly insured do not understand how their insurance works or how to use it to get the care they need. Across the country, advocacy groups, insurers, hospitals, and clinics are encountering newly insured people struggling to translate their new health insurance into health care, and many are employing outreach and educational programs to teach people how to enjoy the benefits of their new coverage. Learn more about the new challenges health care providers are encountering, and about how a group of organizations in Philadelphia is responding to that challenge, in this New York Times … Read More

Posted in Affordable Care Act

PA Aging Waiver Program Struggles With Backlog

A Pennsylvania program to help the elderly remain in their own homes instead of moving into nursing homes is struggling with backlogs. The state’s Aging Waiver Program is a Medicaid program that enables those who meet certain medical and financial criteria to receive assistance in their own homes from nurses and home health aides rather than go into a nursing home. Currently the program serves more than 32,000 people – nearly twice as many as it did six years ago – but applications are taking as long as two months to process.  The biggest challenge is verifying financial eligibility, but the state recently added staff to help address the backlog. Learn more about Pennsylvania’s Aging Waiver Program in this Pittsburgh … Read More

Posted in Pennsylvania Medicaid policy

IOM Releases Graduate Medical Education Report

‘’…there is an unquestionable imperative to assess and optimize the effectiveness of the public’s investment in GME (graduate medical education).” So says the Institute of Medicine (IOM) in its new report Graduate Medical Education That Meets the Nation’s Health Needs. The IOM also calls for “significant changes to GME financing and governance to address current deficiencies and better shape the physician workforce for the future.” The report notes that government today, mostly through Medicare, plays the primary role in financing graduate medical education.  It observes that while there is a common perception that the nation faces a shortage of physicians, simply increasing the number of residency slots that Medicare supports – a limit set in 1997 – without addressing geographic … Read More

Posted in Pennsylvania Medicaid policy
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