Archive for January 2013
The Pennsylvania Health Law Project has published its January 2013 newsletter. Targeted to the very population that Pennsylvania’s safety-net hospitals serve, this month’s newsletter includes features on the benefits of Medicaid expansion under the Affordable Care Act, Medicaid eligibility, and the uninsured in Pennsylvania. It also includes links to articles and features relevant to the state’s low-income population and the health care providers who serve them. See the Pennsylvania Health Law Project’s January 2013 newsletter here.
Pennsylvania will soon begin paying primary care providers more for the services they deliver to their Medical Assistance patients. Under the Affordable Care Act, state Medicaid programs are required to pay primary care providers Medicare-level fees for calendar years 2013 and 2014. This policy was adopted as part of a broader effort to recruit more physicians to serve Medicaid patients at a time when Medicaid enrollment will increase significantly in most states. Now, the Pennsylvania Department of Public Welfare (DPW) is presenting its plan for how it will go about implementing this federal requirement. DPW has issued a new Medical Assistance Bulletin titled “Medical Assistance Program Fee for Select Primary Care Services and Physician Attestation Form” that identifies eligible providers … Read More
While many of the nation’s governors have ideological problems with many aspects of the Affordable Care Act, it appears that more of them are preparing to accept one major facet of the bill with which they particularly disagree: Medicaid expansion. When the law passed, the mandatory expansion of Medicaid eligibility was one of its most controversial aspects and encountered a great deal of resistance from many governors. When the Supreme Court ruled last year that the mandate was unconstitutional, many governors indicated that they would decline the now-optional Medicaid expansion. But as the time for implementing the Medicaid expansion draws closer, more governors are concluding that the lure of millions, and even billions, of “free” federal Medicaid matching dollars is … Read More
Democratic members of the state Senate Appropriations Committee held a hearing in Philadelphia to promote expansion of the state’s Medicaid (Medical Assistance) program. Participating legislators took testimony from representatives of a number of organizations that support Medicaid expansion, which is an optional component of the Affordable Care Act. The Safety-Net Association of Pennsylvania (SNAP) supports Medicaid expansion in the state. Governor Corbett has not yet announced his decision on Medicaid expansion but is thought to be leaning against it. The General Assembly members who held the hearing are in the minority party in the state senate. Read more about the hearing, the issues, and the testimony offered in this Philadelphia Inquirer article.
States would be permitted to require greater cost-sharing from Medicaid recipients under a new regulation proposed by the federal Centers for Medicare & Medicaid Services (CMS). The proposed regulation, which also addresses matters involving state Children’s Health Insurance Programs (CHIP) and health insurance exchanges, would permit states to impose increased co-pays for non-emergency use of hospital emergency rooms and for non-preferred prescription drugs. The cost-sharing for non-emergency use of emergency rooms would be limited to eight dollars for Medicaid recipients with incomes between 100 percent to 150 percent of the federal poverty level but would have no limit for those whose income is beyond 150 percent of the federal poverty level. Cost-sharing requirements of low-income patients pose a particular challenge … Read More
No sooner did hospitals in western Pennsylvania breathe a sigh of relief over escaping the worst possible scenarios in the fiscal cliff crisis than they looked ahead and saw the fiscal cliff sequel: March 1, when all Medicare payments will be cut two percent unless Congress acts to prevent that reduction. With Medicare accounting for 40 percent, 50 percent, and even 60 percent of revenue in some western Pennsylvania hospitals, providers are concerned about the impact the two percent sequester could have on their overall financial health. Such a loss would be especially hard to bear for the area’s safety-net hospitals, which typically have fewer insured patients than other hospitals and therefore are more dependent on their Medicare revenue. Learn … Read More
The relative lack of spending cuts included in the fiscal cliff/Medicare doc fix deal passed by Congress last week could increase the pressure to reduce costs in key safety-net programs like Medicare, Medicaid, and Social Security. Or so some policy analysts believe. Many members of Congress supported the fiscal cliff bill only reluctantly because of it lacked the bigger spending cuts they sought, the thinking goes. Now, with another fiscal cliff deadline looming on March 1, when the previously passed sequestration law takes effect, many who compromised last week will be demanding bigger cuts in exchange for their vote. As a result, Medicare and Medicaid, two of the federal government’s fastest-growing expenses, are expected to be targets for those in … Read More
The Pennsylvania Department of Public Welfare has published a notice that it will increase the fees Medical Assistance pays for selected primary care services. The pay raise, funded 100 percent by the federal government, is part of the Affordable Care Act. For further information about the pay raise, which physicians qualify for it, and how they can receive the pay raise, see the notice here, in the Pennsylvania Bulletin. In addition, members of the Safety-Net Association of Pennsylvania (SNAP) have received a detailed memo outlining the terms of the Medicaid primary care pay raise. Members who have not seen the memo and others who would like a copy can request it at firstname.lastname@example.org.
Writing in the Pottstown Mercury, Pennsylvania Insurance Commissioner Michael Consedine has outlined why the Corbett administration chose not to develop the health insurance exchange that is one of the centerpieces of the 2010 Affordable Care Act. Mr. Consedine’s explanation mirrors that offered last month by Pennsylvania Governor Tom Corbett: the federal government did not provide enough information and guidance to enable the state to develop its own exchange. (Go here for a summary of Governor Corbett’s op-ed piece and a direct link to that piece.) As a result of this decision, Pennsylvania will use a health insurance exchange developed for it by the federal government. Read Mr. Consedine’s guest column in the Pottstown Mercury here.