Archive for October 2019
While Pennsylvania does not have a mandatory work requirement for its Medicaid population, the state is taking a new approach to encouraging Medicaid beneficiaries to pursue work. It is asking them if they want to work and then, if they say they do, directing them to help finding training an jobs. As reported by Kaiser Health News, Starting early next year, the Pennsylvania Medicaid agency under Democratic Gov. Tom Wolf will ask people when they enroll if they want job training assistance. It will then require its private Medicaid managed-care organizations to connect those who want help to local employment specialists and follow up to make sure they got it. The Wolf administration has resisted legislative efforts to impose a … Read More
A core group of safety-net hospitals, led by SNAP members, has filled the gap left by the closure of Hahnemann University Hospital, another safety-net hospital, in Philadelphia. The Philadelphia Business Journal reports that since Hahnemann’s closing was announced during the summer, ER volume has risen 15 percent, admissions have risen 12 percent, and births have risen more than 50 percent at Thomas Jefferson University Hospital, a SNAP member. Meanwhile, SNAP member Pennsylvania Hospital has seen its ER visits rise nine percent, SNAP member Penn Presbyterian Medical Center has seen its ER volume increase five percent, and SNAP member the Hospital of the University of Pennsylvania has seen its ER volume rise five percent. Patient volume also has risen significantly at … Read More
Pennsylvania will spend more than $4 million on health-related services in the North Philadelphia Enterprise Zone, an area in which nearly 13 percent of the state’s Medicaid population resides. This area is served almost exclusively by Pennsylvania safety-net hospitals and recently suffered a major loss when one of those providers, Hahnemann University Hospital, closed its doors. According to a SNAP analysis, more than 50 percent of the patients previously served by Hahnemann will now turn for care to SNAP members Thomas Jefferson University Hospital (18.3 percent), Pennsylvania Hospital (11.3 percent), the Hospital of the University of Pennsylvania (nine percent), Penn Presbyterian Medical Center (4.7 percent), Jefferson Health Northeast (4.1 percent), and Mercy Hospital Philadelphia (3.2 percent). The $4 million will … Read More
Insurance premiums will rise on Pennsylvania’s new health insurance exchange in 2020, the Wolf administration has announced. 2020 will mark the first year Pennsylvania operates its own health insurance exchange under the Affordable Care Act. Previously, Pennsylvanians shopped for health insurance on the federal health insurance exchange. Pennsylvania rates will rise an average of four percent for individual plans and 9.7 percent for small groups, the state Insurance Department has announced. All insurers that offered plans in 2019 will do so again in 2020 and the exchange will include a new insurer and increased choice in some of the state’s 67 counties. Beginning in 2020, residents of only six counties will have only a single insurer offering individual plans. Learn … Read More
Pennsylvania’s new Medicaid preferred drug list is presented in an October 10, 2019 state Medical Assistance Bulletin. The Department of Human Services bulletin outlines the purpose of the new PDL, provides background information, and describes how the PDL was developed and will work. In addition, it lists the past Medical Assistance Bulletins rendered obsolete by the new bulletin and describes the prior authorization procedures that will be employed when the new program takes effect on January 1, 2020. Finally, the bulletin includes a comprehensive list of the prescription drugs on the new PDL. See the October 10 PDL Medical Assistance Bulletin here.
The Pennsylvania Health Law Project has published its September 2019 newsletter. Included in this month’s edition are articles about: changes in federal “public charge” regulations and their implications for immigrants who are currently enrolled in Medicaid or considering applying to participate in the program; the right of participants in programs sponsored by the state’s Department of Drug and Alcohol Programs to continue receiving services while they appeal denials of services or reductions of services; changes in the application process for state-paid home and community-based services; and the continued implementation of the Community HealthChoices program of managed long-term services and supports for low-income seniors. Go here for articles about these and other subjects.
Pennsylvania’s planned shift to a preferred drug list for its Medicaid program is the subject of a new analysis of the projected impact of such a change. Earlier this year, the Department of Human Services announced its intention to implement a preferred drug list in the state’s Medicaid program. That PDL would apply to both the fee for service and managed care Medicaid programs. During this year’s budget proceedings, Pennsylvania’s Human Services Code was amended to require an analysis of “the projected cost to the medical assistance managed care organization [sic] and the projected supplemental rebates that could be obtained” by moving to a PDL. That analysis has now been completed. It concluded that the state …will save $85 million … Read More
State Medicaid programs focused on ensuring that beneficiaries keep their doctor appointments are increasingly looking to ride-sharing services to supplement the providers already participating in their medical transportation programs. Today, Lyft is working with approximately 35 state Medicaid programs while Uber, at least so far, participates only in Arizona’s program. While ride-sharing is not going to replace other medical transportation programs – for one thing, most Uber and Lyft cars are not equipped to serve individuals with serious disabilities – they can help supplement services that today typically require patients to reserve rides days ahead of time and then share van rides with other patients. To facilitate the use of ride-sharing services, several state governments have eased regulations that require … Read More
When a safety-net hospital in Philadelphia closed recently, many predicted a crisis. But there was no crisis. Instead, patients previously served by Hahnemann University Hospital, a Pennsylvania safety-net hospital that served especially large numbers of Medicaid and uninsured patients, are now being served by other safety-net hospitals in Philadelphia: mostly, Jefferson Health, the University of Pennsylvania Health System, Einstein Healthcare Network, and Temple University Hospital. All report increased volume in their emergency rooms, more ambulance arrivals, and more inpatient admissions, but at least so far, they also report that they are comfortably handling the increased patient volume created when Hahnemann closed its emergency room and discharged its last patients in July. Learn more in the Philadelphia Inquirer article “Hahnemann’s end … Read More
In a letter to members of Pennsylvania’s congressional delegation, SNAP has asked those members to support another two-year delay of Medicaid disproportionate share (Medicaid DSH) cuts mandated by the Affordable Care Act. In the message, SNAP notes the important role Medicaid DSH payments play in helping private safety-net hospitals care for the many uninsured patients who continue to turn to them for care. If the cut is not delayed, Pennsylvania will see its Medicaid DSH allotment from the federal government fall 40 percent in FY 2020 and 80 percent annually from FY 2021 through FY 2025. See SNAP’s message to PA delegation members here.