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Archive for September 2017

MACPAC Meets

The Medicaid and CHIP Payment and Access Commission met recently in Washington, D.C. Among the issues MACPAC commissioners discussed during their two-day meeting were: delivery system reform incentive payment programs Medicaid enrollment and renewal processes managed care oversight monitoring and evaluating section 11115 demonstration waivers Medicaid coverage of telemedicine services MACPAC advises the administration, Congress, and the states on Medicaid and CHIP issues.  It is a non-partisan agency of the legislative branch of government. Go here to find background information on these and other subjects as well as links to the presentations that MACPAC staff made to the commissioners during the meetings.

Posted in Federal Medicaid issues

PA Medicaid Director Honored

Leesa Allen, deputy secretary of the Pennsylvania Department of Human Services’ Office of Medical Assistance Programs and state Medicaid director, has been appointed to the board of directors of the National Association of Medicaid Directors. See the Wolf administration’s news release about Ms. Allen’s appointment here.

Posted in Pennsylvania Medical Assistance

State Withholding Some Provider Medicaid Payments

With the state budget still lacking a plan to raise revenue to underwrite expenses, the Wolf administration is beginning to withhold payments to the state’s creditors. Including those who provide services to the more than 2.8 million Pennsylvanians enrolled in the state’s Medicaid program. Last week the Wolf administration announced that it withhold $1.2 billion in Medicaid provider payments. Unless the problem is resolved, more state payments could be withheld in the coming weeks. Learn more about what the Wolf administration is doing and how it might affect Medicaid and Medicaid providers in this Philadelphia Inquirer article.  

Posted in Pennsylvania proposed FY 2018 budget

Overutilization of ERs May Not be as Great as Perceived

Far fewer hospital emergency room visits are for medical problems better addressed in other settings, according to a new study. In a review of six years worth of data encompassing 424 million ER visits, researchers found that only 3.3 percent of those visits were truly “avoidable,” with the avoidable visits mostly involving problems ERs are not equipped to address, such as dental and mental health issues. This finding flies in the face of the conventional wisdom that people turn too quickly to hospital ERs for routine medical problems or use ERs because they lack access to more appropriate care. Learn more about the study and its findings in this Fierce Healthcare article or go here for a link to the … Read More

Posted in Uncategorized

Leave 340B Alone, CMS Advisory Group Says

The Centers for Medicare & Medicaid Services should not significantly reduce Medicare payments for some prescription drugs. Or so says one of CMS’s own advisory panels. The agency’s Advisory Panel on Outpatient Prospective Payment reached this conclusion after listening to testimony from hospital industry stakeholders who told of the savings the federal government’s 340B prescription drug discount program produces and how those savings enable hospitals in low-income areas to help low-income patients who would not otherwise be able to afford their drugs and help improve access to care for low-income patients with very limited health care options. The panel’s recommendation came just a month after CMS proposed reducing Medicare reimbursement for 340B drugs from its current level, average sales price … Read More

Posted in Medicare, Pennsylvania safety-net hospitals, Uncategorized
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