Pennsylvania Medicaid laws and regulations Archives - Page 2 of 10

PA Health Policy Update for Friday, December 16

The following is an update of selected state health policy developments in Pennsylvania for the week of December 12-16, 2022. (Some of the language used below is taken directly from state documents.)

Department of Human Services

The Department of Human Services has issued Medical Assistance Bulletins addressing requirements for prior authorization and the type of information that will be needed, as of January 9, to evaluate the medical necessity of prescriptions for:

Department of Health

The Department of Health (DOH) is working to implement Act 128 of 2022, which requires temporary health care services agencies to register with DOH. Under the act, temporary health care services agencies are agencies that provide temporary health care personnel (RNs, LPNs, nurse aides, or direct care staff) to long-term-care nursing facilities, personal care homes, or assisted living residences. DOH has developed a survey for long-term-care facility administrators so it can compile information about temporary health care services agencies operating in Pennsylvania. Long-term-care facility officials can go here to complete the brief survey.
DOH has issued an alert advising providers of an outbreak of measles in neighboring Ohio, informing providers about the symptoms they should look for among possible measles patients and how to prevent, test for, and treat measles. The alert also reminds providers that they are required to report measles cases to the state. Learn more from this health alert.
DOH has issued an alert updating providers on its latest guidance for treating COVID-19. The alert notes that the most common strains of the virus cannot be treated by the monoclonal antibodies that were effective against earlier strains and that the federal government currently authorizes no such products for use in treating COVID-19 patients. Despite this, selected anti-viral therapeutics are still available to treat such patients. Learn more from this health alert.

COVID-19: By the Numbers

The number of new COVID-19 cases reported daily in Pennsylvania remained steady over the past week but still at an elevated post-Thanksgiving level. The number of new deaths remains within the usual range for recent months.
According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19, on ventilators because of the virus, and in hospital ICUs rose, but just slightly, over the past week.
The CDC reports a modest increase over the past week in the seven-day rolling average of new daily COVID-19 hospital admissions.
As of December 14, 52 Pennsylvania counties were experiencing high rates of community transmission of COVID-19; 14 were experiencing substantial rates of community transmission; and one county was experiencing a moderate rate of community transmission. This represents deterioration from the previous week, when 39 Pennsylvania counties experienced high rates of community transmission of COVID-19, 25 experienced substantial rates of community transmission, and three experienced moderate rates of community transmission.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs recommends that businesses that provide addiction treatment and supports consider training employees and volunteers regularly on preparing for and responding to an active shooter incident. Learn more from this message from the department to stakeholders.

Pennsylvania Health Care Cost Containment Council

PHC4 has released “Hospital Performance Report – October 2020 through September 2021 Data,” which presents information about the performance of Pennsylvania acute-care hospitals for 13 common medical conditions. Among the factors reported are hospital-specific mortality, 30-day readmission ratings, case volume, and hospital charges for patients between October 1, 2020 and September 30, 2021. The report also looks at changes in statewide rates over time. For additional information see PHC4’s news release; a report summary; an introduction to the report; a summary of key findings; downloadable data sets; technical notes; and data about Medicare payments.

jsteinbock2022-12-16T21:54:49+00:00December 16th, 2022|COVID-19, Medical Assistance Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations|Comments Off

PA Health Policy Update for Friday, December 9

The following is an update of selected state health policy developments in Pennsylvania for the week of December 5-9, 2022. (Some of the language used below is taken directly from state documents.)

Shapiro-Davis Transition

Governor-elect Shapiro announced that he will appoint Uri Monson, the chief financial officer of the School District of Philadelphia, as Budget Secretary. He also announced Jennifer Selber will be appointed General Counsel and Larry Hailsham, Jr. will be Executive Deputy Chief of Staff. Selber currently serves as the Executive Deputy Attorney General of Pennsylvania in charge of the criminal division and Hailsham most recently served as the Shapiro campaign’s political director.

General Assembly

Democrats and Republicans continue to struggle over control of the state House. On Wednesday Representative Joanna McClinton (D-Philadelphia) was sworn in during an unannounced ceremony as majority leader. Republicans swiftly denounced the swearing-in as an “illegitimate power grab.” In addition, Representative Summer Lee (D-Allegheny County) and Representative Austin Davis (D-Allegheny County) formally submitted their resignations on Wednesday. At the same time they won re-election to those seats Ms. Summer was elected to Congress and Mr. Davis was elected Lieutenant Governor. Their resignations, along with the passing of Representative Tony DeLuca (D-Allegheny County), make the current breakdown in the state House 101 Republicans and 99 Democrats.
The state Senate released its 2023 session calendar through June. The calendar can be viewed here.

Department of Human Services

The Department of Human Services (DHS) has announced its intent to allocate $18.034 million in state and federal funds for FY 2023 Medicaid disproportionate share hospital payments (Medicaid DSH) to acute-care general hospitals that qualify as a trauma center. DHS also is amending the qualifying criteria and payment methodology for these payments for newly accredited trauma centers and hospitals seeking trauma center accreditation. See the announcement and learn more about the changes in the qualifying criteria and payment methodology in this Pennsylvania Bulletin notice. Public comments are due within 30 days.
DHS has issued a Medical Assistance Bulletin to inform providers about updates to the statewide Preferred Drug List (PDL) that take effect on January 9. Find the bulletin here.
DHS has issued Medical Assistance Bulletins addressing requirements for prior authorization and the type of information that will be needed, as of January 9, to evaluate the medical necessity of prescriptions for:
DHS has posted guidance for providers on procedure code/modifier combinations to be used when requesting home accessibility durable medical equipment and durable medical equipment repairs in the Medicaid fee-for-service program. Find the instructions here.
DHS is updating the Medical Assistance fee schedule for disposable breast milk collection and storage bags and breast pump replacement supplies. Learn about the new fees and new procedure codes to accompany them from this Pennsylvania Bulletin notice.
Beginning on December 16, providers will find a new question on the electronic provider enrollment application: “Will your provider agency be rendering Personal Care Services or Home Health Care Services that are subject to EVV [electronic visit verification]?” DHS has posted information for providers about what this question means and how they should approach answering it.

COVID-19: By the Numbers

The number of new COVID-19 cases reported daily in Pennsylvania rose nearly 30 percent in the past week, an increase possibly attributable to social gatherings over the Thanksgiving holiday. The number of new deaths remains within the usual range for recent months.
According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19, on ventilators because of the virus, and in hospital ICUs remains relatively unchanged.
The CDC reports a 22 percent increase over the past week in the seven-day rolling average of new daily COVID-19 hospital admissions.
As of December 7, 39 Pennsylvania counties are experiencing high rates of community transmission of COVID-19; 25 are experiencing substantial rates of community transmission; and three counties are experiencing moderate rates of community transmission. This is almost identical to the previous week.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has issued an information bulletin explaining that as a result of a new Pennsylvania law passed last month, private and public treatment and rehabilitation facilities may not deny addiction treatment to individuals based solely on a negative result on a drug test. This policy takes effect on January 1. Learn more from this information bulletin.
The Department of Drug and Alcohol Programs has announced that it has awarded nearly $19 million in grant funding through its substance use disorder loan repayment program to help substance use disorder treatment professionals repay their outstanding qualifying educational loans. More than 280 practitioners, including case managers, counselors, licensed social workers, physician assistants, and registered nurses, shared in the funding. Learn more from this department news release.

State Board of Nursing

The State Board of Nursing proposes amending its process for reactivating nursing licenses. Learn more from this Pennsylvania Bulletin notice. Public comments on the proposed changes are due within 30 days.

jsteinbock2022-12-09T21:00:26+00:00December 9th, 2022|COVID-19, DSH hospitals, Medicaid supplemental payments, Medical Assistance Bulletin, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for Friday, December 2

The following is an update of selected state health policy developments in Pennsylvania for the week of November 28 to December 2, 2022. (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf has announced the availability of more than $9 million in state grant funding for Single County Authorities to establish or expand crisis stabilization services for individuals with co-occurring mental health and substance use disorders. Grants of up to $3 million will be awarded to eligible Single County Authorities and can be applied toward a range of activities, including construction and building infrastructure, staffing, and programming. Learn more about how the state envisions counties using this money from this announcement from the governor’s office.

Governor-Elect Shapiro

The Shapiro-Davis transition team announced that Dana Fritz will serve as chief of staff in a new Shapiro administration. Immediately prior to joining the incoming administration, Ms. Fritz, a long-time aide to Shapiro, served as his campaign manager. Find additional information about the transition here.

Revenue Collection Update

The Department of Revenue has released its monthly revenue update for November. General Fund revenue collections were $201.9 million, or 6.8 percent, below estimate for the month. The shortfall is due, in part, to personal income tax revenue being deposited in December rather than November. Fiscal year-to-date General Fund collections total $15.7 billion, which is $183.2 million, or 1.2 percent, above estimate.

Department of Human Services

The Department of Human Services (DHS) has announced its intent to update the qualifying criteria and payment methodology for Medicaid disproportionate share hospital (Medicaid DSH) and supplemental payments to Medical Assistance-enrolled and qualifying emergency departments in acute-care general hospitals by adding references to the report used in determining the eligibility for and the payment amounts beginning FY 2022-2023. This announcement appears to be a codification of current state policy. Learn more from this Pennsylvania Bulletin notice.
DHS has announced that it plans to expand the Living Independence for the Elderly (LIFE) Program to serve Carbon County and Monroe County as one area and is soliciting expressions of interest in serving this area. Learn more about the LIFE program, DHS’s intentions for Carbon and Monroe counties, and the process for pursuing an opportunity to establish a LIFE program in those counties from this Pennsylvania Bulletin notice.
CMS has written to states to remind them that with the passage of the Inflation Reduction Act, Medicaid and Children’s Health Insurance Program (CHIP) programs will be required to provide coverage for approved adult vaccines recommended by the CDC’s Advisory Committee on Immunization Practices (ACIP) without cost-sharing for certain enrollees beginning October 1, 2023. Learn more from this CMS notice.
DHS has circulated the minutes of the October 26 meeting of the Medical Assistance Advisory Committee’s consumer subcommittee. Find those minutes here.

Department of Health

The Department of Health (DOH) issued a press release announcing its plans to distribute approximately $11.7 million in federal CDC funding to help long-term-care facilities build resilience to sustain quality care. The money will be invested for purposes such as workforce development, staff retention, and infrastructure developments that support infection prevention control and emergency preparedness. Eligible applicants include skilled nursing facilities, personal care homes, assisted living facilities, and intermediate care facilities. Learn more about the program and find links to additional information about it here. The deadline for applying for funding is December 31.
DOH has issued a health alert informing health care providers of a recent increase in reports of mushroom poisoning received by poison control centers in the state. The majority of these cases have involved individuals consuming wild mushrooms foraged from backyards, public parks, wooded areas, and other locations in the southeastern part of the state. Learn more from this department health alert.
DOH has updated the guidelines and fees that health care providers and facilities may charge in response to requests for production of medical charts or records. Learn more, including the new fees, from this Pennsylvania Bulletin notice.
In preparation for the holiday season, DOH has established ten temporary COVID-19 testing and home test distribution sites across the state. Go here for information about the location and hours for these sites.

COVID-19: By the Numbers

According to the CDC, the number of new COVID-19 cases reported daily in Pennsylvania and the number of new deaths has remained steady in recent weeks, with the state averaging about 1400 new daily cases and 16-20 new daily deaths.
According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19, on ventilators because of the virus, and in hospital ICUs remains relatively steady as well.
The CDC reports a modest decrease in the seven-day rolling average of new daily COVID-19 hospital admissions.
As of November 30, 38 Pennsylvania counties are experiencing high rates of community transmission of COVID-19; 26 are experiencing substantial rates of community transmission; and three counties are experiencing moderate rates of community transmission.

Pennsylvania Health Care Cost Containment Council

PHC4 has issued “COVID-19 Disaster Emergency Report,” to provide data on the effect of the COVID-19 emergency on the financial performance of Pennsylvania hospitals and health care facilities. According to the report, Pennsylvania hospitals and health systems reported $206 million in COVID-19 costs, between related expenses and revenue losses, for the period April-June of 2022. Total COVID-19-related expenses and lost revenue reported by Pennsylvania hospitals and health systems through December 2021 are $7.8 billion but these figures do not reflect emergency funding provided under federal or state laws. Learn more from this PHC4 news release and the report itself.

Stakeholder Events

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – December 7

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, December 7 at 10:00. Interested parties can join the meeting in person or via webinar. For information about the location of the meeting and how to join virtually, see this DHS notice.

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – December 7

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, December 7 at 1:00. Go here to register to participate.

Department of Health – Infant Hearing Screening Advisory Committee – December 8

The Infant Hearing Screening Advisory Committee will hold a public meeting in Harrisburg on Thursday, December 8 at 1:00; individuals also may participate virtually. For more information about the meeting, including its location and how to join virtually, see this Pennsylvania Bulletin notice.

Department of Aging – Pennsylvania Long-Term Care Council – December 8

The Department of Aging’s Pennsylvania Long-Term Care Council will meet publicly on Thursday, December 8 at 10:00. For information about how to attend in person or virtually, see this Pennsylvania Bulletin notice.

Patient Safety Authority – December 8

The board of directors of the state’s Patient Safety Authority will meet virtually on Thursday, December 8 at 1:00. Learn about how to register for and participate in this meeting from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – December 8

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, December 8 at 10:00. Go here to register to participate.

jsteinbock2022-12-05T13:53:45+00:00December 2nd, 2022|COVID-19, Federal Medicaid issues, Medicaid supplemental payments, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for Friday, November 18

The following is an update of selected state health policy developments in Pennsylvania for the week of November 14-18, 2022. (Some of the language used below is taken directly from state documents.)

Governor-Elect Shapiro

Governor-Elect Josh Shapiro held a press conference Wednesday, November 16 along with Governor Wolf and Lieutenant Governor-Elect Austin Davis to discuss the gubernatorial transition process. The governor-elect announced that Akbar Hossain, who previously served as his campaign’s policy director, will be executive director of the transition. Amanda Warren, formerly director of finance for the campaign, will serve as executive director of the inauguration. Additional transition announcements will be made in the coming weeks. Further information about the transition will be available here.

General Election Update

State Representative Todd Stephens (R-151) conceded to his challenger, Melissa Cerrato (D), yesterday afternoon. Representative Stephens’ concession gives Democrats the 102 seats needed to control the state House of Representatives; Republicans have 101 seats. The initial path forward for Democratic control is unclear, however, because of three impending vacancies in the Democratic caucus that will require special elections in early 2023.

General Assembly Update

The state House and Senate briefly convened for voting session this week – the final voting session of the year. Both chambers will return to Harrisburg for the commencement of the new legislative session on January 3.
The Senate Health & Human Services Committee held a hearing on Tuesday to examine the Behavioral Health Commission’s recommendations for the allocation of $100 million earmarked in the FY 2023 budget. Testimony and a recording of the hearing may be viewed here.
The Senate Republican and Democratic caucuses held leadership elections this week for the new legislative session. Senator Kim Ward (R-39) was elected the state’s first female Senate President Pro Tempore. Senator Joe Pittman (R-41) was elected majority leader and Senator Scott Martin (R-13) was chosen chairman of the Appropriations Committee. Senator Jay Costa (D-43) was re-elected by his caucus to serve as minority leader. A complete list of the Senate Republican leadership team can be found here and a list of the Senate Democratic leadership team can be found here.

Department of Human Services

As of December 5, DHS is adding a new procedure code to the Medical Assistance fee schedule for COVID-19 tests provided to Medicaid beneficiaries and removing the previous code for those tests. Learn more from this Pennsylvania Bulletin notice.
DHS will increase Medical Assistance fees for certain ambulance transportation services beginning on January 1. Learn more, including the new fees, from this Pennsylvania Bulletin notice.
Pennsylvania’s Independent Regulatory Review Commission has received final form rulemaking from DHS that would effectively rescind a provision in existing regulations that prohibits providers from co-locating or leasing space to another provider within a provider’s office. This change was originally proposed in July 2021 and the commission is expected to approve the change at its December 8 meeting. Find notice of the action in this Pennsylvania Bulletin listing.
Next month, DHS’s Office of Long-Term Living will submit a proposed amendment to Pennsylvania’s OBRA 1915(c) home and community-based waiver to the Centers for Medicare & Medicaid Services (CMS). To view a side-by-side comparison of the current and revised language and to see the amendment in its entirety, go to the OLTL Waiver Amendments, Renewals, and Accompanying HCBS Transition Plans webpage and select “2023 OBRA Waiver Amendment” under “Additional Resources.” For additional information about the proposed amendment and how to submit written comments, see this Pennsylvania Bulletin notice. The deadline for submitting comments has been extended to December 14.
Next month, DHS’s Office of Long-Term Living will submit to CMS a proposed amendment to Pennsylvania’s Community HealthChoices 1915(c) home and community-based waiver. To view a side-by-side comparison of the current and revised language and see the amendment in its entirety, go to the OLTL Waiver Amendments, Renewals, and Accompanying HCBS Transition Plans webpage and select “2023 Community HealthChoices (CHC) Waiver Amendment” under “Additional Resources.” Learn more about the proposed amendment from this Pennsylvania Bulletin notice. The deadline for submitting comments has been extended to December 14.
DHS is making available for public review and comment the Office of Long-Term Living’s proposed home and community-based services provider sites that qualified for heightened scrutiny under CMS requirements. Learn more about the types of sites to which this requirement applies and DHS’s actions to bring them into compliance with federal standards from this Pennsylvania Bulletin notice.

COVID-19: By the Numbers

According to the CDC, the number of new COVID-19 cases reported daily in Pennsylvania over the past week declined 18 percent while the number of deaths remains unchanged. The state is now averaging more than 1400 new reported cases a day and about 19 daily deaths.
According to the Department of Health, the number of Pennsylvanians hospitalized with COVID-19 and on ventilators because of the virus remains relatively steady but the number in hospital ICUs fell 16 percent from the last week after two weeks of rising totals.
The CDC reports a modest decrease in the seven-day rolling average of new daily COVID-19 hospital admissions.
As of November 18, 27 Pennsylvania counties are experiencing high rates of community transmission of COVID-19; 34 are experiencing substantial rates of community transmission; and six counties are experiencing moderate rates of community transmission.

Pennsylvania Health Care Cost Containment Council

PHC4 has published “Financial Analysis 2021: Rehabilitation • Psychiatric • Long-Term Acute Care • Specialty: An Annual Report on the Financial Health of Pennsylvania Non-GAC Hospitals.” The report’s highlights include:

During FY 2021, the operating margin for rehabilitation hospitals was 9.19 percent, for psychiatric hospitals was negative 2.86 percent, for long-term acute-care hospitals was 8.98 percent, and for specialty hospitals was negative 11.76 percent.
During FY 2021, the total margin for rehabilitation hospitals was 12.04 percent, for psychiatric hospitals was negative 3.02 percent, for long-term acute-care hospitals was 7.76 percent, and for specialty hospitals was 9.9 percent.
As a group, the foregone dollar value of uncompensated care for non-general acute-care hospitals decreased 6.19 percent, or $1.1 million, from $18.7 million during FY 2020 to $17.7 million in FY 2021. Uncompensated care as a percentage of net patient revenue in FY 2021 among non-general acute-care hospitals ranged from 0.22 percent for long-term acute-care hospitals to 1.44 percent for psychiatric hospitals.

Learn more about the PHC4 report from this news release and the report itself. In addition, go here to download data from the report in Excel format.

Stakeholder Events

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – December 7

Department of Health – Infant Hearing Screening Advisory Committee – December 8

DHS – Medical Assistance Advisory Committee – Consumer Subcommittee – December 7

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, December 7 at 1:00. Go here to register to participate.

DHS – Medical Assistance Advisory Committee – December 8

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, December 8 at 10:00. Go here to register to participate.

jsteinbock2022-11-18T22:22:41+00:00November 18th, 2022|COVID-19, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for Friday, September 23

The following is an update of selected state health policy developments in Pennsylvania for the week of September 19-23, 2022. (Some of the language used below is taken directly from state documents.)

General Assembly

The state House and Senate convened for voting session this week. The following is an overview of certain health-related legislative activity.

The House of Representatives unanimously passed House Bill 2425, which requires the Department of Health or Department of Human Services to report allegations of older adult abuse to local area agencies on aging and the Department of Aging. The bill was received in the Senate and referred to the Aging & Youth Committee.
The House unanimously passed House Bill 2806, which requires DHS to establish a public awareness campaign about programs and services available for first responders, health care workers, other frontline workers, and their families experiencing mental health issues related to the COVID-19 pandemic. The bill was received in the Senate and referred to the Health & Human Services Committee.
The House passed House Bill 2800, which amends the Medical Practice Act to address an issue related to the licensure of prosthetists, orthotists, pedorthists, and orthotic fitters in Pennsylvania. The bill was received in the Senate and referred to the Consumer Protection & Professional Licensure Committee.
The House Insurance Committee unanimously reported out of committee Senate Bill 225, which seeks to streamline and standardize the process for prior authorization of medical services.
The House Children & Youth Committee favorably reported Senate Bill 522, which requires all pregnant women and children in Pennsylvania to receive blood tests to detect lead poisoning.
The Senate Health & Human Services Committee held an informational hearing to examine the tick crisis in Pennsylvania. A recording of the hearing and witness testimony may be viewed here.
The Senate Banking & Insurance Committee favorably reported Senate Bill 1330, which requires insurance coverage for genetic counseling and genetic testing for the BRCA1 and BRCA2 gene mutation if a person is diagnosed with breast or ovarian cancer or has a family history of breast or ovarian cancer, and Senate Bill 1225, which provides enhanced coverage of MRIs and ultrasounds for women with certain risk factors.
The Senate Judiciary Committee favorably reported House Bill 1393, which seeks to prevent overdose deaths by legalizing fentanyl test strips for personal use, and House Bill 2527, which expands Pennsylvania’s “Good Samaritan” law to cover all opioid reversal medicines approved by the FDA.

The Senate will reconvene on Monday, October 17 and the House on Monday, October 24.

Department of Human Services

The Department of Human Services (DHS) has published two Pennsylvania Bulletin notices about FY 2023 Medicaid disproportionate share (Medicaid DSH) payments:
The first notice conveys DHS’s intention to make $257.760 million in total (state and federal) payments upon approval by the Centers for Medicare & Medicaid Services for inpatient DSH, outpatient supplemental, and direct medical education payments based on the current state plan qualification criteria and distribution methodologies.
The second notice is DHS’s annual publication listing each facility qualifying for certain disproportionate share hospital payments.
DHS has posted information about how new providers and those reactivating a service location that has been closed for two years or longer can obtain an electronic provider enrollment application from the PROMISe provider portal landing page. Go here to learn more.
DHS has issued a Medical Assistance Bulletin to announce that the Medical Assistance program will cover vaccine counseling visits for beneficiaries under the age of 21 for vaccines provided through the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit even when no vaccines are administered. This policy took effect on September 20. Find that bulletin here.
DHS has issued a Medical Assistance Bulletin to announce the annual update of the Medical Assistance program’s EPSDT Program Periodicity Schedule and Coding Matrix. The update took effect on September 19. Find that bulletin here.
DHS has issued a Medical Assistance Bulletin to inform providers that the Medical Assistance program will cover COVID-19 vaccine counseling visits for beneficiaries under 21 even when a COVID-19 vaccine is not administered. Go here to learn more.
DHS has issued a Medical Assistance Bulletin to inform Medical Assistance providers that it has added CPT codes 0041A and 0042A to the Medical Assistance program fee schedule for the administration of the COVID-19 vaccine manufactured by Novavax. The update is effective as of July 13. Find that bulletin here.
DHS has published a notice in the Pennsylvania Bulletin announcing the addition of procedure codes to the Medical Assistance program fee schedule for specific dental services, effective with dates of service on and after May 2. Find that notice here.
DHS has published a notice in the Pennsylvania Bulletin announcing the addition of procedure codes to the Medical Assistance program fee schedule for the provision of private duty nursing services provided through home health agencies to Medical Assistance beneficiaries under 21 years of age effective with dates of service on and after October 1. Find that notice here.
DHS has announced the proposed assessment amount, the proposed assessment methodology, and the estimated aggregate impact on nursing facilities that will be subject to the state’s nursing facility assessment program beginning in FY 2023. Specifically, DHS proposes modifying the assessment methodology by including in the lower rate tier nursing facilities with at least 90,000 Medical Assistance days and with an overall occupancy rate of 77 percent or higher based on calendar year 2021 resident days and also calling for a uniform $3.76 increase of the 2022 assessment rates for both tiers. Learn more from this Pennsylvania Bulletin notice.
DHS’s Medical Assistance Advisory Committee has shared the presentations made during its September 22 meeting by its

It also has published a list of Medical Assistance Bulletins issued since its June 23 meeting.

DHS has received an estimated $12 million from the federal government for the Money Follows the Person program to continue to support new and existing activities that meet the criteria for that program’s funding. The Money Follows the Person program enables states to leverage federal funding to help Medicaid beneficiaries who live in institutions receive services they need in community settings instead. Learn more about the funding and the specific purposes for which it is currently being used from this DHS news release.

COVID-19: By the Numbers

The weekly average of newly reported COVID-19 cases in Pennsylvania and COVID-related deaths continues to hold relatively steady: roughly 2500 new daily cases and 20 new deaths with weekly variances of about 10 percent.
To date, Pennsylvania has registered 2.7 million confirmed cases of COVID-19, 570,000 probable cases, and more than 47,000 deaths from the disease.
The number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus also remains relatively unchanged.
According to the CDC, the seven-day moving average of new hospital admissions for COVID-19 in Pennsylvania was 195 admissions a day over the past week.
Sixty-six of Pennsylvania’s 67 counties continue to have a high rate of community transmission of COVID-19. Philadelphia County is currently experiencing “only” a substantial rate.

Monkeypox

DHS has published a notice in the Pennsylvania Bulletin announcing the addition of procedure codes to the Medical Assistance program fee schedule for use when billing for diagnostic laboratory testing for the orthopoxvirus and for the administration of monkeypox vaccines effective with dates of service on and after July 26. Find that notice here.
The CDC has posted an updated map showing the distribution of 23,364 confirmed cases of monkeypox in the U.S. as of September 21, up only slightly from 23,117 cases on September 15. 713 of those cases were in Pennsylvania, up from 684 a week ago.
As of September 19, 446 of those Pennsylvania monkeypox cases were in Philadelphia. Learn more about monkeypox in Philadelphia from the city Department of Public Health’s monkeypox web page.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has released a new report about the performance of Pennsylvania hospitals for four types of cardiac procedures: coronary artery bypass graft, percutaneous coronary intervention for a heart attack, percutaneous coronary intervention without a heart attack, and transcatheter aortic valve replacement. The report includes hospital ratings for in-hospital mortality, seven-, 30-, and 90-day readmissions, and extended post-operative length of stay. It also documents case volumes, hospital charges, and statewide trends and offers other statistics. To find PHC4’s news release on the report, a summary, the report itself, downloadable data sets, information about Medicare payments, and more, go here.

Stakeholder Events

Pennsylvania Health Care Cost Containment Council – Special Executive Committee Meeting – September 26

The Pennsylvania Health Care Cost Containment Council (PHC4) has scheduled a meeting of its Special Executive Committee on Monday, September 26 at 3:00. The meeting will be held virtually. An agenda will be available here 24 hours in advance. Contact rgreenawalt@phc4.org at least 24 hours in advance for participation instructions.

Department of Health – Health Research Advisory Committee Meeting – October 3

The Department of Health’s Health Research Advisory Committee will meet virtually on Monday, October 3 at 10:00 to hold a formal vote on upcoming priorities. Learn more about the meeting and how to participate from this Pennsylvania Bulletin notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – October 4

The Medical Assistance Advisory Committee’s managed long-term services and supports subcommittee will meet in Harrisburg on Tuesday, October 4 at 10:00; interested parties also may participate virtually. For information about the location of the meeting or to register to participate virtually, see this DHS notice.

Department of Human Services Preventing Workplace Injuries – October 6

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on “Protecting and Preserving our Workforce by Preventing Common Injuries” among health care workers on Thursday, October 6 at 2:00. Learn more about the webinar and how to register to participate from this notice.

DHS – Office of Mental Health and Substance Abuse Services and Office of Developmental Programs – Suicide Prevention – October 21

The Department of Human Services’ Office of Mental Health and Substance Abuse Services (OMHSAS) and the Office of Developmental Programs will host a quarterly “Statewide Positive Approaches & Practices” meeting that will share the most recent research and resources to help people with mental health and behavioral challenges, intellectual disabilities, autism, and other developmental disabilities live everyday lives. The specific subject of the meeting, to be held on Friday, October 21 at 9:00, will be suicide prevention and intervention. Find the meeting agenda and information about how to register to participate from this DHS notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

The Department of Health’s Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board will hold its next meeting on Tuesday, October 25 at 9:30. The meeting location will depend on COVID-19 mitigation efforts at that time. If the meeting can be held in person it will be in Room 129 in the Pennsylvania Health and Welfare Building at 625 Forster Street in Harrisburg. If the meeting is held virtually it will be held at bit.ly/ABC_MAP. To dial in, call 267-332-8737, conference ID 440 338 696#. Learn more from this Pennsylvania Bulletin notice.

jsteinbock2022-09-23T21:43:19+00:00September 23rd, 2022|COVID-19, Medicaid supplemental payments, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for Friday, September 16

The following is an update of selected state health policy developments in Pennsylvania for the week of September 12-16, 2022. (Some of the language used below is taken directly from state documents.)

General Assembly

The state House convened for voting session this week. The following is an overview of selected health-related legislative activity.

The House unanimously passed House Bill 1630, which grants the Pennsylvania Auditor General the authority to audit managed care contracts and subcontracts with pharmacy benefit managers in Medicaid. The bill was received in the Senate and referred to the Health & Human Services Committee.
The House unanimously passed House Bill 1693, which requires nursing home residents to be notified at the time of their admission that they have the option of having legal representation to assist with applying for Medicaid benefits. The bill will now be sent to the Senate.
The House Insurance Committee favorably reported Senate Bill 1201, which ensures coverage for early refills of prescription eye drops at 70 percent of the original prescription price, and House Bill 2499, which adopts the National Association of Insurance Commissioners’ model law requiring insurers, with exceptions for small insurers, to conduct an annual risk assessment.
The House Professional Licensure Committee favorably reported House Bill 2800, which amends the Medical Practice Act to address an issue related to the licensure of prosthetists, orthotists, pedorthists, and orthotic fitters in Pennsylvania.
The House Republican Policy Committee held an informational meeting on Monday to examine the Supreme Court’s recent decision to eliminate the existing requirement that a medical professional liability action may only be filed in the county in which the cause of action occurred. A recording of the meeting and testimony submitted to the committee may be viewed here.
The House Human Services Committee favorably reported House Bill 2686, as amended, which establishes a grant program to support the start-up costs of a behavioral health collaborative care model in medical practices.
The House Children & Youth Committee held an informational meeting this week to examine “Child & Adolescent Fatality Trends & Community Responses.” A video recording of the hearing may be viewed here.

The state House and Senate will be in session next Monday (9/19), Tuesday (9/20), and Wednesday (9/21). The following is an overview of selected health-related committee meetings next week.

The House Insurance Committee will convene on Tuesday, September 20 at 10:00 a.m. to consider Senate Bill 225, which seeks to streamline and standardize the process for prior authorization of medical services.
The Senate Health & Human Services Committee will hold an informational hearing on Tuesday, September 20 at 11:00 a.m. on the tick crisis in Pennsylvania.
The House and Senate Democratic Policy Committees will hold a joint hearing on Friday, September 23 to discuss Senate Bill 860 and House Bill 1848 and the need for Pennsylvania to establish a statewide rape-kit tracking system.

Department of Human Services

The Department of Human Services (DHS) has issued a Medical Assistance Bulletin notifying providers of updates to the Medical Assistance program fee schedule for adult vaccines. Find the bulletin here.
DHS has extended its calendar for remittance advice (RA) electronic transfer and mailing dates into November. Find the updated calendar here.
DHS has published information about improvements in how providers can update their enrollment summary in the state’s PROMISe provider internet portal. Find the notice here.
DHS has revised its list of drug companies participating in the state’s Medicaid drug rebate program. Find the updated list here.
In July, DHS proposed new regulations governing the delivery of psychiatric rehabilitation services, and in particular, on the use of telehealth in the delivery of those services. Now, Pennsylvania’s Independent Regulatory Review Commission has published its analysis of the proposed regulation and shared comments submitted by stakeholders in response to the proposed changes. Find the commission’s analysis and stakeholder comments in this Pennsylvania Bulletin notice.
DHS has issued a Medical Assistance Bulletin to announce that it has issued an updated School-Based ACCESS Program provider handbook. Find that bulletin and the updated handbook here.
DHS has posted a notice announcing to stakeholders that it has not yet calculated Medicaid hospice rates for FY 2023 and explaining its process for completing those calculations and notifying affected parties. Find that notice here.

Behavioral Health Commission for Adult Mental Health

The Behavioral Health Commission for Adult Mental Health created to develop recommendations for how to allocate $100 million appropriated for adult mental health purposes in the state’s FY 2023 budget held its fourth public meeting this week. The first part of the meeting focused on workforce development issues, with participants identifying the biggest challenges in workforce development as recruitment, retention, licensing, lack of funding for loan repayment and salary increases, lack of career pathways and pipelines, and burnout.

After additional discussion, commission members decided they should organize their spending recommendations into four categories: workforce ($37 million of the $100 million available), expanding services ($36.7 million), criminal justice ($23.3 million), and other ($3 million); they also discussed priorities within each category. The commission’s final report and recommendations should be presented to the legislature next week but no money will be spent until the General Assembly, which will only meet a few more days this year, specifically authorizes it. Learn more about the Behavioral Health Commission for Adult Mental Health from its section of the DHS web site.

Department of Health

The Department of Health has notified licensed providers that although the CDC now considers individuals up to date with their COVID-19 vaccinations only if they have had a dose of the new bivalent booster shot, providers should continue to consider individuals up to date if they have received either a monovalent or bivalent booster shot on the recommended schedule. Learn more from the Department of Health’s letter to providers.

COVID-19: By the Numbers

The weekly average of newly reported COVID-19 cases in Pennsylvania and COVID-related deaths continues to hold relatively steady.
The number of people hospitalized with COVID-19 and in hospital ICUs and on ventilators because of the virus also remains relatively unchanged.
According to the CDC, 74.5 percent of Pennsylvanians five years of age and older are now vaccinated.
Sixty-five of Pennsylvania’s 67 counties continue to have a high rate of community transmission of COVID-19. Delaware and Philadelphia counties are currently experiencing “only” substantial rates.

Monkeypox

The CDC has posted an updated map showing the distribution of 23,117 confirmed cases of monkeypox in the U.S. as of September 15, up from 21,504 cases on September 1. 684 of those cases were in Pennsylvania, up from 624 a week ago.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs is offering online training on substance use disorder confidentiality. This updated training incorporates changes based on passage of Pennsylvania Act 33, the Pennsylvania Drug and Alcohol Abuse Control Act, in July. Learn how to receive the training from this Department of Drug and Alcohol Programs notice. Participants can earn PCB continuing education credits.

Stakeholder Events

DHS – Medical Assistance Advisory Committee Consumer Subcommittee – September 21

The consumer subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Wednesday, September 21 at 1:00. Go here to register to participate.

DHS – Medical Assistance Advisory Committee – September 22

DHS’s Medical Assistance Advisory Committee will meet virtually on Thursday, September 22 at 10:00. Go here to register to participate.

Department of Health – Infant Hearing Screening Advisory Committee – September 22

The Department of Health’s Infant Hearing Screening Advisory Committee will hold a virtual public meeting on Thursday, September 22 at 1:00. For information about how to participate, see this Pennsylvania Bulletin notice.

Pennsylvania Rare Disease Advisory Council Stakeholder Summit – September 22

The Rare Disease Advisory Council will hold a stakeholder summit on Thursday, September 22. The summit will feature panels on gene therapy, newborn screening, and the results of the council’s Patient Needs Assessment Survey. Learn more about the stakeholder summit here.

Department of Human Services – Special Populations/Dementia Issues September 22

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a webinar on how facilities can help community members understand what dementia is, how it affects people, and how individuals can make a difference in the lives of those touched by dementia. The webinar, to be held on Thursday, September 22 at 2:00, is especially recommended for community liaisons, non-clinical teams, nurse educators, service coordinators, and volunteers. Learn more from this webinar notice.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – October 4

DHS – Office of Mental Health and Substance Abuse Services and Office of Developmental Programs – Suicide Prevention – October 21

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

jsteinbock2022-09-16T21:36:30+00:00September 16th, 2022|COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for Friday, July 29

The following is an update of selected state health policy developments in Pennsylvania for the week of July 25-29, 2022. (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf has issued an executive order on reproductive health services that addresses the delivery of legal reproductive health services in Pennsylvania; investigations of reproductive health services initiated by or in other states regarding services that are legal in Pennsylvania; the protection of health care and other professionals involved in the provision of reproductive health services; communication about reproductive health services; and circumstances under which the governor will not approve interstate extradition for alleged violations of reproductive health laws in other states that are not violations of reproductive health laws in Pennsylvania. Learn more from the governor’s executive order on reproductive health services.

Governor Wolf has filed a lawsuit against the General Assembly for what the Wolf administration calls its “…unconstitutional attempt to ban abortion in Pennsylvania” through an amendment of the state’s constitution. The governor’s suit also cites what he believes to be procedural flaws in the manner in which the legislature adopted the proposed amendment. Learn more from this news release from the governor’s office.

Executive Branch Regulatory Agenda

Pennsylvania Executive Order 1996-1 requires all agencies under the jurisdiction of the governor to submit for semi-annual publication an agenda of regulations under development or consideration. These agendas are compiled to give the regulated community advance notice of regulatory activity. This week’s Pennsylvania Bulletin includes the latest such publication of regulations under development and consideration. They include:

Department of Aging – matters involving older adult living centers and the Pennsylvania Community Adult Respite Program.
Department of Health – matters involving long-term-care facilities.
Department of Human Services – matters involving psychiatric rehabilitation services, Medical Assistance manual changes, the Office of Developmental Programs, county children’s and youth social programs, child residential and day treatment facilities, medical marijuana in facilities, adult protective services, crisis regulations, children with intellectual disabilities and autism, child care regulations, the county mental health and intellectual disabilities fiscal manual, and psychiatric residential treatment facilities.

Learn more about what these agencies are contemplating and find contact information for seeking additional information from this Pennsylvania Bulletin notice.

Department of Human Services

The Department of Human Services has extended its calendar of remittance advice (RA) delivery dates, mailing of checks, and electronic transfers of funds into early September. Find the updated schedule here.

Department of Health

The Wolf administration has expanded the Department of Health’s naloxone standing order to combat the rise of opioid overdoses to include ZIMHI, an intra-muscular version of naloxone in the form of an injection device that comes as a single-dose pre-filled syringe or a carton containing two cases of the pre-filled syringes. Pennsylvanians can present a copy of the standing order at pharmacies to obtain naloxone and can obtain the standing order here. Learn more from this news release.

COVID-19: By the Numbers

The daily average of newly reported COVID-19 cases rose 12 percent over the past week and the number of COVID-related deaths rose just slightly.
The number of people hospitalized with COVID-19 rose modestly over the past week, the number in hospital ICUs remained similar to last week, and the number on ventilators fell 20 percent and that number itself is modest.
All 67 Pennsylvania counties are currently experiencing a high rate of community transmission of COVID-19, up from 63 counties last week.

Monkeypox

The CDC has posted an updated map showing the distribution of 4639 confirmed cases of monkeypox in the U.S. as of July 27 – more than twice as many as a week ago. 114 of those cases were in Pennsylvania.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has issued its latest legislatively mandated report on the financial impact of COVID-19 on the state’s hospitals; the report covers the first quarter of the 2022 calendar year. Hospitals that submitted data to PHC4 (71 percent of the state’s hospitals and health systems) reported $418.8 million in COVID-19-related costs – a combination of COVID-related expenses and revenue losses – during that period and a collective COVID-related revenue loss of $95.7 million. The figures do not reflect COVID-related emergency funding from either the state or federal government. Learn more from this PHC4 news release and the report itself.

Stakeholder Events

Department of Health – State Child Death Review Team – August 10

The Department of Health’s State Child Death Review Team will hold a virtual public meeting on

Wednesday, August 10 at 1:00. The state’s Child Death Review Program provides training and technical assistance to local child death review teams. Learn more about the State Child Death Review Team and how to join the August 10 meeting from this Pennsylvania Bulletin notice.

Department of Health – Pennsylvania Achieving Better Care by Monitoring All Prescriptions Board – October 25

jsteinbock2022-07-29T19:57:25+00:00July 29th, 2022|COVID-19, Pennsylvania Bulletin, Pennsylvania Medicaid laws and regulations|Comments Off

PA Health Policy Update for Friday, June 3

The following is an update of selected state health policy developments in Pennsylvania for the week of May 31 to June 3, 2022. (Some of the language used below is taken directly from state documents.)

General Assembly

The state House and Senate will return to Harrisburg for session the week of June 6. The Senate will be in session on Monday (6/6), Tuesday (6/7), and Wednesday (6/8). The House will be in session on Tuesday (6/7), Wednesday (6/8), and Thursday (6/9).
The House Health Committee will hold a joint hearing with the Environmental Resources & Energy Committee on “Oil and gas byproducts: powering modern medicine and our healthcare system.” The hearing will take place on Tuesday, June 7 at 10:00 a.m.
The House Insurance Committee will hold an informational meeting on Wednesday, June 8 at 10:00 a.m. to examine cybersecurity and insurance data security.
The Senate Health & Human Services Committee will meet on Tuesday, June 7 at 10:30 a.m. to consider the following bills.
- Senate Bill 571, which establishes a uniform time-frame for distribution of SNAP benefits.
- Senate Bill 1198, which seeks to promote and improve the availability of and access to assisted living residences.
- Senate Bill 1202, which requires health insurers to cover the use of medically prescribed pasteurized donor human milk in inpatient and outpatient settings for children under the age of 12 months.
- House Bill 2401, which makes permanent two COVID-19 waivers that permit non-physician practitioners to order and oversee orders for home health care services and permits the continued use of remote supervisory visits by registered nurses.

Revenue Collection Update

The Independent Fiscal Office (IFO) has released its Monthly Revenue Update for May. General Fund revenue collection exceeded estimate by $459.1 million for the month. For the fiscal year to date Pennsylvania has received $5.5 billion more than projected. The IFO reported that increased revenue collections continue to be driven by strong sales and use tax, personal income tax, and corporate net income tax payments.

Department of Human Services

The Department of Human Services (DHS) has published a Medical Assistance Bulletin to inform Medical Assistance providers that it has added a CPT code to the MA fee schedule for the administration of a third dose of the Pfizer pediatric COVID-19 vaccine. Find that notice here. The notice is retroactive to January 3.
DHS has published a Medical Assistance Bulletin to inform Medical Assistance providers that it has added CPT codes to the MA fee schedule for the administration of Pfizer’s ready-to-use novel COVID-19 vaccine. Find that notice here. The notice is retroactive to January 3.
The managed care delivery system subcommittee of DHS’s Medical Assistance Advisory Committee has posted a draft file note summarizing its May 12 public meeting. Find that draft here.

Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) has released a new tool states can use to prepare for the eventual end of the COVID-19 public health emergency and return to normal Medicaid and CHIP eligibility and enrollment operations. This tool highlights the ten fundamental actions states need to complete to prepare for unwinding when the Medicaid continuous enrollment requirement ends. Find it here.

CMS has issued a letter to state Medicaid programs updating its 2022 SSI and spousal impoverishment standards. These measures affect financial eligibility rules (the “spousal impoverishment rules”) that apply when married individuals seek coverage of certain long-term services and supports. Find the letter and the new standards here.

Department of Health

The Department of Health is working with Philadelphia’s Department of Public Health to confirm and investigate what appears to be the first case of monkeypox in Pennsylvania and one of only 21 currently suspected in the U.S. Learn more from this Philadelphia Department of Public Health news release.

The Department of Health’s Bureau of Epidemiology and Bureau of Facility Licensure and Certification have notified skilled nursing facilities of modifications of the reporting process for skilled nursing facilities with ongoing outbreaks of COVID-19. Find that notice here.

COVID-19: By the Numbers

For the first time in more than two months daily COVID-19 case counts fell, declining from a seven-day average of 4238 on May 25 to 3552 on June 1.
The seven-day average of COVID-19-related deaths fell by more than half, from 36 to 15, over the same period of time.
Despite the decline in new cases, the number of Pennsylvanians hospitalized with COVID-19 rose, but only slightly (three percent) over the past week.
The number of these patients on ventilators and hospital intensive care units held steady over the past week.
Sixty-six of Pennsylvania’s 67 counties are currently experiencing high rates of community transmission of COVID-19; Juniata County was the exception, with a substantial rate of community transmission.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has awarded a grant of $1.4 million to continue the Pennsylvania Perinatal Quality Collaborative’s work in improving perinatal health outcomes. Learn more about the grant, the program, and the grant recipient from this department news release.

Independent Regulatory Review Commission

Pennsylvania’s Independent Regulatory Review Commission has issued comments on proposed regulations governing long-term-care facilities that were published on March 19. See these comments in this Pennsylvania Bulletin notice.

Stakeholder Events

Department of Human Services – Medical Assistance Advisory Committee – Managed Care Delivery System Subcommittee – June 9

The Medical Assistance Advisory Committee’s managed care delivery system subcommittee will meet virtually on Thursday, June 9 at 10:00. Go here for the meeting agenda and information about how to participate.

Department of Human Services – Long-Term Care Learning Network/Nursing Facilities – June 9

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a special population webinar on polypharmacy challenges in nursing homes on Thursday, June 9 at 2:00. The webinar is especially targeted for skilled nursing facility medical directors, directors of nursing, pharmacy staff, and recreational therapy. To learn more about the virtual webinar and how to participate, go here.

Department of Aging – Pennsylvania Long-Term Care Council – June 9

The Department of Aging’s Pennsylvania Long-Term Care Council will meet in Harrisburg on Thursday, June 9 at 10:00; the meeting also will be available virtually. For information on the location of the meeting and how to participate virtually, see this Pennsylvania Bulletin notice.

Department of Human Services – Long-Term Care Learning Network/Nursing Facilities – June 23

DHS’s Long-Term Care Learning Network, part of its quality strategy for nursing facilities, is offering in collaboration with the Community HealthChoices managed care organizations and the Jewish Healthcare Foundation a “learning collaborative” webinar in which participants in past Long-Term Care Learning Network events share information about best practices for avoiding hospitalizations from nursing homes. The webinar will be held on Thursday, June 23 at 2:00 and the deadline to sign up to share best practices is June 1. For further information about the webinar, sharing best practices, and participating virtually, go here.

DHS – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee Meeting – July 6

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet in Harrisburg on Wednesday, July 6 at 10:00; the meeting also will be available virtually. For further information about the location of the meeting and how to participate virtually, see this announcement.

jsteinbock2022-06-03T20:40:29+00:00June 3rd, 2022|COVID-19, Federal Medicaid issues, long-term care, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance|Comments Off

PA Health Policy Update for the Week of April 18-22

The following is an update of selected state health policy developments in Pennsylvania for the week of April 18-22, 2022. (Some of the language used below is taken directly from state documents.)

Governor Wolf

Governor Wolf has signed House Bill 245, which reduces the graduate medical training required for international medical graduates from three years to two years; removes the limit on the number of affiliated facilities at which a doctor with an institutional license may practice or teach; and expands and clarifies the scope of practice of temporarily licensed physicians.

General Assembly

The state House will be in session next Monday (4/25), Tuesday (4/26), and Wednesday (4/27). The Senate is in recess.
The House Professional Licensure Committee will meet on Monday, April 25 at 10:00 a.m. to consider House Bill 1956, which creates a license for certified anesthesiologist assistants.
The House Health Committee will convene on Tuesday, April 26 at 9:30 a.m. to consider the following bills.
- House Bill 398, which requires a non-custodial parent of a child to enroll their child in their own health insurance plan before seeking Medicaid coverage.
- House Bill 2441, which gives legislative agencies access to records information for research purposes under the Vital Statistics Law.
- Senate Bill 317, which provides for the authority to prescribe antibiotics to treat sexually transmitted infections without having examined the individual for whom the drug is intended, in accordance with the Expedited Partner Therapy in the Management of Sexually Transmitted Diseases guidance issued by the CDC.
- Senate Bill 818, which seeks to align procedures permitted in licensed ambulatory surgery centers with those of the federal Centers for Medicare & Medicaid Services (CMS).

Department of Human Services

Act 2 of 2022 appropriated $225 million to support the health care workforce needs of hospitals and behavioral health providers. The law directed that the funding be used strictly for recruitment and retention payments to direct care staff. Entities receiving payments under Act 2 must submit a report to the Department of Human Services (DHS) documenting staff retention payments by September 30, 2022 and a report on staff recruitment spending by December 31, 2022. DHS has posted an FAQ describing how Act 2 works and has added to that FAQ a template for submitting the required reports. Find the FAQ and the report template here.
DHS has updated its calendar for delivering Remittance Advice and corresponding checks to extend into early June.
DHS has issued a Medical Assistance Bulletin to announce the addition of new procedure codes to the Medical Assistance program fee schedule for the provision of personal care services that are provided through home health agencies to Medicaid beneficiaries under 21 years of age. Find that bulletin here.
DHS has posted a notice to Medical Assistance fee-for-service providers reminding them of the recommended documentation needed to support the review of authorization requests for private duty/shift nursing and home health aide service hours provided to children under the age of 21. Find that notice here.
DHS has shared the minutes of the February 23 meeting of the Medical Assistance Advisory Committee’s consumer subcommittee.
DHS has updated its “Monthly Physical Health Managed Care Program Enrollment Report” to include March 2022 data.

Department of Health

Keara Klinepeter has resigned as Pennsylvania’s Acting Health Secretary. She will be replaced by the state’s Physician General, Dr. Denise Johnson. Learn more from this Wolf administration news release.
The Secretary of Health issued a letter to the hospital community clarifying that the intention of the recently issued innovative hospital guidance was to preserve access to care in rural communities in a financially sustainable way. Find a copy of that letter here.
The Department of Health has updated its guidance to providers caring for adults and children with multisystem inflammatory syndrome.
The Department of Health has updated its information about state-sponsored free COVID-19 testing sites to reflect that it currently operates such sites in Berks, Blair, Centre, and Clinton counties and at Edinboro University in Erie. Learn more about the locations and hours of operation in this department news release.

COVID-19: By the Numbers

Daily COVID-19 case counts climbed for the fourth consecutive week. The state’s seven-day average of new cases rose 26 percent, from 1067 cases on April 14 to 1343 on April 21.
The seven-day average of COVID-19-related deaths, which has long been declining, rose during the past week from 10 on April 13 to 16 to April 21.
The rising number of COVID-19 cases in Pennsylvania has led to increases in some but not all measures of COVID-19-related hospital care. In the past week the number of Pennsylvanians hospitalized with the virus rose 13 percent and has now risen 21 percent since the beginning of the month. The number of COVID-19 patients in hospital ICUs rose 15 percent in the past week but remains modest. The number of such patients being treated on ventilators, on the other hand, declined 22 percent and remains very low.
During the past week nine Pennsylvania counties, up from five last week, experienced high rates of community transmission of COVID-19; three counties, down from five last week, experienced a low rate of transmission; 20 counties, up from 15 last week, experienced a substantial rate of community transmission; and the remaining 35 counties experienced a moderate rate.

Pennsylvania Health Care Cost Containment Council (PHC4)

PHC4 has released a fourth quarter 2021 report on the effect of COVID-19 on hospitals and health care facilities in Pennsylvania. In the report, PHC4 aggregates data on fourth quarter of 2021 COVID-19 expenses and lost revenue as reported by hospitals and health systems to show the impact of the public health emergency on those institutions. The data in the report reflects financial performance for fewer than half of the hospitals in the state and does not include emergency funding the providers received from the federal or state government. Learn more from this PHC4 news release and the agency’s “COVID-19 Disaster Emergency Report.”

Stakeholder Events

Behavioral Health Services for the Nursing Facility Population – April 26 and May 3

The Department of Human Services’ Office of Long-Term Living, Office of Mental Health and Substance Abuse Services (OMHSAS), the HealthChoices behavioral health managed care organizations, and the Community HealthChoices managed care organizations will host a joint webinar on the importance of providing behavioral health services in nursing facilities and making sure nursing facilities know how to gain access to these services. The webinar will be held two more times and the material presented will be the same at each session. The webinars will be recorded. The session on Tuesday, April 26 will be held at 2:00; go here for more information and to register to participate. The session on Tuesday, May 3 also will be held at 2:00; go here for more information and to register to participate.

Department of Human Services – Medical Assistance Advisory Committee – Consumer Subcommittee – April 27

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, April 27 at 1:00. Go here to register to participate.

Department of Human Services – Medical Assistance Advisory Committee – April 28

The Medical Assistance Advisory Committee will meet virtually on Thursday, April 28 at 10:00. Go here to register to participate.

Special Pharmaceutical Benefits Program Advisory Council – April 28

The Department of Human Services’ Special Pharmaceutical Benefits Program Advisory Council will meet by teleconference on Thursday, April 28 at 10:00. Join the meeting at 866-588-4789 and use conference ID code 211 418 005#.

Patient Safety Authority – April 28

The Patient Safety Authority will hold a virtual public meeting of its board on Thursday, April 28 at 1:00 p.m. For information about how to participate see this Pennsylvania Bulletin notice.

jsteinbock2022-04-22T18:48:43+00:00April 22nd, 2022|Coronavirus, COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

PA Health Policy Update for the Week of April 11-15

The following is an update of selected state health policy developments in Pennsylvania for the week of April 11-15, 2022. (Some of the language used below is taken directly from state documents.)

General Assembly

The state House and Senate convened for session in Harrisburg this week.
The House concurred with the Senate’s amendment to House Bill 245 and sent it to the governor’s desk. House Bill 245 reduces the clinical residency requirement from three years to two years for an applicant who has graduated from an international medical college to receive licensure in Pennsylvania.
The House passed on third and final consideration House Bill 2401, which makes permanent two COVID-19 waivers that permit non-physician practitioners to order and oversee orders for home health care services and permits the continued use of remote supervisory visits by registered nurses, and House Bill 2419, which expands access to outpatient psychiatric care via telemedicine. These bills will now be sent to the Senate for consideration.
The Senate passed on third and final consideration Senate Bill 1172, which authorizes the establishment of Sexual Assault Nurse Examiner (SANE) programs by hospitals, mandates the creation of a comprehensive list of such programs, and authorizes a grant program to establish and support SANE services. The bill was received in the House and referred to the Health Committee.
The House Health Committee held an informational meeting on Tuesday, April 12 regarding “Opioids in the Commonwealth: Lessons learned and next steps.” A recording of the meeting may be viewed here.
The House Veterans Affairs and Emergency Preparedness Committee favorably reported House Bill 2097, which makes permanent a COVID-19 regulatory waiver that permits certified emergency personnel, such as firefighters with specific first-aid, CPR, and emergency vehicle training, to drive ambulances with an EMT on board.
The House Aging & Older Adult Services Committee held an informational meeting on Tuesday, April 12 to examine long-term-care facility workforce challenges. A recording of the meeting may be viewed here.
The Senate Health & Human Services Committee met on Tuesday, April 12 and favorably reported the following bills.
- Senate Bill 749, which seeks to provide clarity for employees and employers regarding current ambiguity in the state’s medical marijuana law concerning the use of medical marijuana in the workplace.
- Senate Bill 1121, which requires the Department of Human Services (DHS) to verify wage records from employers and the Department of Revenue for Medicaid and SNAP beneficiaries.
- Senate Bill 1124, which requires DHS to check death certificates at the Bureau of Vital Statistics against Medicaid and SNAP beneficiaries.
- Senate Bill 1188, which seeks to increase awareness, testing, and access to treatment for Lyme disease.

A recording of the hearing may be viewed here.

Department of Human Services

The Department of Human Services (DHS) has posted a file note summarizing the March 10 meeting of the Medical Assistance Advisory Committee’s managed care delivery system subcommittee.

DHS has announced the addition of two procedure codes to the Medical Assistance fee schedule for the provision of personal care services by home health agencies to beneficiaries under 21 years of age, effective with dates of service on and after May 1, 2022. Find those procedure codes in this Pennsylvania Bulletin notice.

Department of Health

The Department of Health (DOH) has updated its guidance for reporting on point-of-care COVID-19 test results to bring Pennsylvania into compliance with revised federal requirements. See the new guidance here.
DOH has updated its information about state-sponsored free COVID-19 testing sites to reflect that it currently operates such sites in Berks, Centre, and Clinton counties and at Edinboro University in Erie. Learn more about the locations and hours of operation in this department news release.
DOH has posted new online resources for providers and the public to learn about and support

Pennsylvanians who may be experiencing symptoms of Alzheimer’s disease and related disorders. The new information comes in response to a law passed by the legislature earlier this year and signed by Governor Wolf requiring the administration to provide such information. Go here to find the resources for providers and here to view resources for the public.

COVID-19: By the Numbers

Daily COVID-19 case counts climbed for the third consecutive week. The state’s seven-day average of new cases rose nearly 24 percent, from 797 cases on April 5 to 986 on April 13.
On the other hand, the number of new COVID-19-related deaths continues to decline, from a seven-day average of 17 on April 5 to just 10 on April 13.
The rising number of COVID-19 cases in Pennsylvania has not led to increases in hospital care for COVID-19 patients: during the past week the number of residents in hospital ICUs because of the virus and being treated with ventilators has remained steady while the number admitted to hospitals has risen only seven percent since the beginning of the month.
During the past week five Pennsylvania counties – up from two last week – experienced high rates of transmission of COVID-19 (Potter, Bradford, Susquehanna, Columbia, and Pike); five counties – the same number as last week – experienced a low rate of community transmission (Bedford, Fulton, Juniata, Elk, and Sullivan); and 15 counties experienced a substantial rate of community transmission while another 42 experienced a moderate rate.

Department of Drug and Alcohol Programs

The Department of Drug and Alcohol Programs has issued a news release describing its recent talks with state Attorney General Shapiro and other officials about how Pennsylvania might use its share of the national opioid settlement – as much as $1.07 billion – to address substance use challenges in the state. Learn more here.

Insurance Department

The Insurance Department has published a policy statement that will permit insurers to ask applicants to voluntarily provide race and ethnicity data on insurance applications in an effort to promote equity initiatives. The new statement of policy ends enforcement of a prohibition on such data collection published in 1969. Learn more about this policy change in this department news release and see the policy statement in this Pennsylvania Bulletin notice.

Stakeholder Events

Department of Health – Spinal Cord Research Advisory Committee – April 21

The Department of Health’s Spinal Cord Research Advisory Committee will meet virtually on Thursday, April 21 at 10:30. The purpose of this meeting is to review the committee’s work, review the status and progress of the current request for applications, reaffirm priorities, evaluate and refine the process to review the next spinal cord research applications, and address emerging issues. For information about how to join the meeting, see this Pennsylvania Bulletin notice.

Behavioral Health Services for the Nursing Facility Population – April 26 and May 3

Department of Human Services – Medical Assistance Advisory Committee – Consumer Subcommittee – April 27

The Medical Assistance Advisory Committee’s consumer subcommittee will meet virtually on Wednesday, April 27 at 1:00. Go here to register to participate.

Department of Human Services – Medical Assistance Advisory Committee – April 28

The Medical Assistance Advisory Committee will meet virtually on Thursday, April 28 at 10:00. Go here to register to participate.

Special Pharmaceutical Benefits Program Advisory Council – April 28

Patient Safety Authority – April 28

The Patient Safety Authority will hold a virtual public meeting of its board on Thursday, April 28 at 1:00 p.m. For information about how to participate see this Pennsylvania Bulletin notice.

Department of Health – Traumatic Brain Injury Advisory Board – May 6

The Traumatic Brain Injury Advisory Board will hold a public meeting on Friday, May 6 at 10:00 at the Pennsylvania Training and Technical Assistance Network, 6340 Flank Drive in Harrisburg, in the Dauphin Conference Room. To learn more about the meeting, and for information about how to participate virtually, see this Pennsylvania Bulletin notice.

Department of Human Services – Medical Assistance Advisory Committee – Managed Long-Term Services and Supports Subcommittee – May 10

The managed long-term services and supports subcommittee of DHS’s Medical Assistance Advisory Committee will meet virtually on Tuesday, May 10 at 10:00. To register to participate, go here.

jsteinbock2022-04-15T20:31:51+00:00April 15th, 2022|Coronavirus, COVID-19, Medical Assistance Bulletin, Meetings and notices, Pennsylvania Bulletin, Pennsylvania Department of Health and COVID-19, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy|Comments Off

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