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Archive for March 2017

Temporarily Gone But Not Forgotten

While last week’s withdrawal of the American Health Care Act at least temporarily halted talk of immediate repeal and replacement of the Affordable Care Act, at least one aspect of that proposed legislation, often discussed in the past, is sure to arise in the future as well:  replacing the current manner in which the federal government matches state Medicaid funding with Medicaid per capita limits or Medicaid block grants. In a new issue brief, the Kaiser Family Foundation examines how a switch to per capita limits or block grants might affect low-income seniors served by both Medicare and Medicaid.  Among the issues the brief addresses are: why such a switch would matter to low-income seniors at all how it might … Read More

Posted in Federal Medicaid issues, Medicare, Pennsylvania safety-net hospitals

CMS Shares Evaluation of Medicare-Medicaid Financial Alignment Efforts

In 2011 the Centers for Medicare & Medicaid Services launched a “Medicare-Medicaid Financial Alignment Initiative” that seeks “…to provide Medicare-Medicaid enrollees with a better care experience and to better align the financial incentives of the Medicare and Medicaid programs.” How is that initiative working so far?  CMS recently released three reports that evaluate different aspects of the program.  Those reports are: “Early Findings on Care Coordination in Capitated Medicare-Medicaid Plans under the Financial Alignment Initiative” “Beneficiary Experience: Early Findings from Focus Groups with Enrollees Participating in the Financial Alignment Initiative” “Issue Brief: Special Populations Enrolled in Demonstrations under the Financial Alignment Initiative” Pennsylvania’s private safety-net hospitals serve especially large numbers of dually eligible Medicare and Medicaid beneficiaries, so such programs … Read More

Posted in Federal Medicaid issues, Medicare, Uncategorized

MACPAC Looks at Medicaid DSH

Hospitals that serve especially large numbers of Medicaid and low-income patients still need Medicaid disproportionate share hospital payments (Medicaid DSH) to avoid red ink despite the expansion of Medicaid and the increase in the number of uninsured people fostered by the Affordable Care Act. So concludes the Medicaid and CHIP Payment and Access Commission (MACPAC) the non-partisan legislative branch agency that advises Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on Medicaid and Children’s Health Insurance Program issues. In its March 2017 report to Congress, MACPAC writes that In both expansion and non-expansion states, deemed DSH hospitals, which are statutorily required to receive DSH payments because they serve a high share of Medicaid-enrolled … Read More

Posted in Federal Medicaid issues, Medicaid supplemental payments

MACPAC Meets, Discusses Medicaid Issues

Members of the non-partisan legislative branch agency that advises Congress, the Secretary of Health and Human Services, and the states on Medicaid and Children’s Health Insurance Program matters met in Washington recently to discuss a number of issues. On the agenda of the Medicaid and CHIP Payment and Access Commission were the following issues: state Medicaid flexibility state Medicaid responses to fiscal pressures a study requested by Congress on mandatory and optional benefits and populations current Medicaid parallels to per capita financing options illustrations of state-level effects of per capita cap design elements high-cost hepatitis C drugs the role of section 1915(b) waivers in Medicaid managed care Because Pennsylvania safety-net hospitals serve so many Medicaid and CHIP participants, MACPAC’s deliberations … Read More

Posted in Federal Medicaid issues, Pennsylvania safety-net hospitals, Uncategorized

PA Proposes Changes in County Assistance Office Operations

The manner in which Pennsylvania operates its county assistance offices would change under a new proposal from the Department of Human Services that was included in Governor Wolf’s proposed FY 2018 budget. Under the plan, the state would consolidate county assistance office back-office operations in five new regional processing centers.  While every county will have what DHS is calling a county assistance office “presence,” the new approach would lead to the lay-off of 70 of the county assistance office program’s nearly 7000 employees. The process of determining Medicaid eligibility in Pennsylvania either begins or works its way through the state’s county assistance offices. Learn more about the proposal to change some aspects of county assistance office operations in this DHS … Read More

Posted in Pennsylvania Medicaid policy

PA Takes Steps to Fight Opioid Epidemic

The Pennsylvania Department of Human Services has announced new steps designed to combat opioid abuse within the state’s Medicaid population. Among those steps are ensuring that only providers registered with the state’s Medicaid program can prescribe opioids and fill opioid prescriptions for Medicaid patients; monitoring the opioid-prescribing practices of participating Medicaid providers and taking actions when those practices are inappropriate; introducing new opioid prescribing guidelines; improving access to naloxone to fight opioid overdoses; expanding drug treatment programs; and more. To learn more, see this news release from the office of Pennsylvania Governor Tom Wolf.

Posted in Pennsylvania Medicaid policy

Health Law Center Comments on Proposed Health Law

The Pennsylvania Health Law Project has issued a statement detailing its perspective on the recently proposed American Health Care Act, which would both repeal and replace the Affordable Care Act of 2010. See that statement here.

Posted in Affordable Care Act, American Health Care Act

MACPAC Meets, Discusses Medicaid, CHIP Issues

The non-partisan legislative branch agency that advises Congress, the Secretary of Health and Human Services, and the states on a variety of Medicaid and State Children’s Health Insurance Program issues met last week in Washington, D.C. Among the issues on the agenda of the Medicaid and CHIP Payment and Access Commission were: the flexibility of states in structuring and administering their Medicaid and CHIP programs state Medicaid responses to fiscal pressures studies requested by Congress on mandatory/optional benefits and populations current Medicaid parallels to per capita financing options illustrations of state-level effects of per capita cap design elements high-cost hepatitis C drugs in Medicaid the role of section 1915(b) waivers in Medicaid managed care Because Pennsylvania safety-net hospitals serve so … Read More

Posted in Federal Medicaid issues

New HealthChoices Contracts Delayed

Pennsylvania’s plan to implement new contracts with HealthChoices physical health managed care plans on June 1 has been put on hold. The reason:  for the second time, companies that lost a public bidding process protested the state’s choices.  The first time, the state threw out all the bids and started over again.  This time the state says it needs more time to deal with the protests, negotiate new contracts, and get the new contractors up and running. In addition to the delay, the new contracts will be phased in at different times in different parts of the state, with the first regional launch now scheduled for January of 2018 and the last a year later. Learn more about why the … Read More

Posted in HealthChoices

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its February 2017 newsletter. Included in this edition are stories about: the potential implications of turning Medicaid into a block grant program the governor’s proposed FY 2018 budget a new federal requirement that hospitals must inform Medicare patients if they are designated as hospitalized under “observation status” counseling services available through PA LINKs Find the latest edition of PA Health Law News here.

Posted in Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania proposed FY 2018 budget
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2012 Safety-Net Association of Pennsylvania