Archive for June 2013
The Central Penn Business Journal has published an interview with new Department of Public Welfare Secretary Beverly Mackereth. Among other issues, Secretary Mackereth addresses Pennsylvania’s high Medicaid costs, Medicaid expansion in the state, and her department’s preparations for implementation of various facets of the Affordable Care Act. Read the complete interview here.
The Affordable Care Act calls for selected primary care providers to receive an increase in their Medicaid fees during calendar years 2013 and 2014. The pay raise, which seeks to bring Medicaid fees to the same level as Medicare rates, is intended to induce more primary care providers to serve Medicaid patients in anticipation of the increase in Medicaid enrollment expected when the Affordable Care Act takes full effect. Eligible providers must complete a form attesting to their eligibility for the pay raise and the Pennsylvania Department of Public Welfare has issued the form and instructions for completing it. Find both the form and the instructions here.
The Pennsylvania Department of Public Welfare (DPW) has published a notice of its intention to implement changes in the Medicaid fee schedule and to update selected prior authorization requirements. Those notices are published here, in the June 22 edition of the Pennsylvania Bulletin, and the changes took effect on June 24. DPW also published a Medical Assistance Bulletin on the procedure code updates and a table showing the updates. Find the bulletin here and the table here.
Pennsylvania state Senate leaders plan to bring a vote to expand the state’s Medicaid program to the Senate floor this week. The bill, according to Senate leaders, will include conditions that will make it more palatable to more conservative Republicans and the governor. Democrats are already thought to support Medicaid expansion. While the bill is considered likely to enjoy solid support in the Senate, it is not clear whether the state House is as interested in Medicaid expansion as envisioned under the federal Affordable Care Act. The Safety-Net Association of Pennsylvania (SNAP) supports Medicaid expansion in the state. Read more about the Senate bill, who is behind it, and what the bill says in this Centre Daily Times article.
The Pennsylvania Health Law Project has released its latest newsletter. Among the issues addressed in the letter are the prospects for Medicaid expansion in Pennsylvania and increased state oversight of the state’s private Medicaid managed care organizations. The newsletter also describes an effort by the U.S. Department of Health and Human Services to encourage all qualified health plans offered through health insurance exchanges to include “essential community providers” in their provider networks. Find the newsletter here, on the web site of the Pennsylvania Health Law Project.
Medicare penalties for hospital readmissions are inappropriately hurting hospitals that serve especially large numbers of low-income patients. That was the message MedPAC conveyed to Congress last week. The agency, which advises Congress on Medicare reimbursement matters, expressed concern earlier this year about the effect of Medicare’s hospital readmissions reduction program on safety-net hospitals, and it articulated that concern more formally in its June report to Congress. As reported by Kaiser Health News, MedPAC found that hospitals where fewer than 3 percent of Medicare patients were low income received an average penalty of 0.21 percent. Hospitals where more than 18 percent of Medicare patients were low income had an average penalty more than twice that, 0.45 percent. As an alternative to … Read More
Corbett administration officials took advantage of a recent public briefing on Medicaid expansion to explain that the governor wants to expand the state’s Medicaid program but is seeking flexibility in how to do so that the Obama administration will not provide. In particular, the administration wants to establish work requirements for new recipients, adjust benefits, and carve out a greater role for private health insurers. The administration continues to negotiate these and other Medicaid expansion-related issues with federal officials. Read more about the issues that the Corbett administration is attempting to address and the response of advocates of Medicaid expansion in this Harrisburg Patriot-News article.
The Stateline web site features a number of new, excellent graphs that depict various aspects of Affordable Care Act-inspired Medicaid expansion. The graphs show where expansion is moving forward, where it has been rejected, and where decisions have yet to be made; where Americans get their health insurance today; who might be eligible for Medicaid; and the cost of Medicaid expansion. Find the graphs here, on the Stateline web site.