Archive for February 2020

Azar: Budget Proposes Reducing Medicaid Matching $

The federal government would reduce its financial commitment to state Medicaid programs under the FY 2021 budget the Trump administration proposed earlier this month. While testifying before the Senate Appropriations Committee’s Subcommittee on Labor, Health and Human Services and Education, Health and Human Services Secretary Alex Azar acknowledged that the administration’s proposed FY 2021 would eliminate the enhanced rate at which the federal government matches state funds used to serve individuals who enrolled in Medicaid through the Affordable Care Act’s Medicaid expansion provision.  That enhanced rate calls for the federal government to pay 100 percent of the costs associated with the Medicaid population during the first year of Medicaid expansion, eventually scaling down to 90 percent after 2020.  Nationally, the … Read More

Posted in Affordable Care Act, Federal Medicaid issues

HealthChoices MCO Seeks to Address Social Determinants of Health

A managed care plan that participates in Pennsylvania’s Medicaid program is slowly dipping its toe into an effort to address the social determinants of health in Philadelphia. United Healthcare, with 57,000 Medicaid members in the city, has placed six homeless members with multiple health problems into apartments in the city – it plans to add four more – and is spending between $1200 and $1800 a month on rent and wrapround services.  Its theory:  with one percent of the population accounting for 22 percent of annual health care spending nation-wide, helping some of that one percent could improve lives while saving a great deal of money. Pennsylvania’s Department of Human Services has awarded nearly $9 million in grants since 2016 … Read More

Posted in Pennsylvania Medicaid, social determinants of health

Fitch: Medicaid Block Grants, MFAR Threaten States, Providers

Medicaid block grants and the proposed Medicaid fiscal accountability regulation (MFAR) pose new financial threats to providers and states, according to Fitch Ratings, the financial rating company. MFAR poses the greater threat, Fitch believes, noting in a new analysis that it could …reduce total Medicaid spending nationally by $37 billion and $44 billion annually…and by $23 billion to $30 billion for hospitals alone.  States, and to some extent providers, would respond to MFAR’s implementation with measures to mitigate the negative fiscal implications. Block grants, through what has been named the Healthy Adult Opportunity program, also pose a threat, with Fitch explaining that Capping federal Medicaid contributions, even for a subset of beneficiaries, poses risks to state budgets and those entities … Read More

Posted in Federal Medicaid issues, Pennsylvania Medicaid, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania

PA Seeks to Connect Medicaid Beneficiaries With Job

Pennsylvania has launched a new program that seeks to help Medicaid beneficiaries who would like to find jobs. The program, called Medicaid Work Supports, is a joint project of the state’s Department of Human Services and Department of Labor & Industry. As described in The Impact, DHS’s weekly newsletter: The Medicaid Work Supports initiative will create a more direct and systematic introduction to employment and training resources available to Pennsylvanians. When people are deemed eligible and enroll in a new Medicaid health plan, they will be asked if they are interested in help finding a job, training programs, and opportunities to get a high school diploma or GED. The referral system will help identify this population for the first time … Read More

Posted in Uncategorized

Verma Responds to MFAR Critics

CMS administrator Seema Verma addresses criticism of her agency’s proposed Medicaid fiscal accountability regulation in a new commentary on the CMS blog. Critics of the so-called MFAR regulation have argued that the Centers for Medicare & Medicaid Services’ proposed regulation, if adopted, will lead to a reduction of federal funding for state Medicaid programs, jeopardize access to care and the financial health of providers by leading to a reduction of supplemental payments to high-volume Medicaid providers, and possibly even force some states to raise taxes to compensate for the loss of federal funding. In her commentary Verma rebuts these criticisms, maintaining that the proposed regulation seeks to ensure that states pay their fair share of their Medicaid partnership with the … Read More

Posted in Federal Medicaid issues, Safety-Net Association of Pennsylvania

340B Déjà Vu: CMS Seeks to Collect Data From Hospitals

For the second time in four months, the federal government has announced its intention to collect data from hospitals and other providers on what they pay for the prescription drugs they purchase through the section 340B prescription drug discount program. Last week the Centers for Medicare & Medicaid Services published a notice announcing its intention to collect this data.  Previously, health care interests sued CMS when it attempted in 2018 to reduce payments to providers for drugs purchased through the 340B program and the court ruled against CMS, maintaining that the agency did not have enough data on hospitals’ acquisition costs for the drugs to justify the proposed payment reduction.  The newly announced data collection effort seeks to rectify that … Read More

Posted in 340b, Pennsylvania safety-net hospitals

Verma Responds to Medicaid Block Grant Critics

Last week the Trump administration unveiled its Healthy Adult Opportunity program, a new, optional, already-controversial approach to structuring state Medicaid programs. Ever since, the program – essentially, Medicaid block grants – has been the subject of criticism from many public officials and health care stakeholders. Now, Centers for Medicare & Medicaid Services administrator Seema Verma, who oversaw the development of Healthy Adult Opportunity, has responded to the program’s critics in an op-ed piece published in the Washington Post.  See her commentary “No, the Trump administration is not cutting Medicaid.”

Posted in Federal Medicaid issues

Health Care Groups Rebel Against Proposed Federal Regulation, Program

The administration’s proposed Medicaid fiscal accountability regulation and its guidance encouraging states to implement Medicaid block grants have incurred widespread opposition among a variety of health care groups. The Medicaid fiscal accountability regulation would, if adopted, impose new restrictions on how states raise their share of their Medicaid spending, potentially limiting state participation in Medicaid or necessitating tax increases to fill the funding gap if long-accepted financing tools are no longer available to them. The Medicaid block grant guidance offers states a blueprint for curtailing their Medicaid costs by imposing limits on that spending that they negotiate with the federal government. Numerous health care groups have expressed reservations or direct opposition to one or both of the proposals.  Among them: … Read More

Posted in Federal Medicaid issues, Safety-Net Association of Pennsylvania

Wolf Administration Proposes New Human Services Initiatives for FY 2021

New human services efforts to support vulnerable populations are a major part of Governor Tom Wolf’s proposed $36.06 billion FY 2021 budget for Pennsylvania. The proposed budget, presented to the state legislature earlier this week, includes the following new initiatives: creating pathways to success in the workforce for low-income Pennsylvanians increasing the minimum wage to $15 increasing Department of Human Services staffing to support licensing and oversight supporting adults in long-term-care facilities legal services for vulnerable populations direct care worker comprehensive training commitment to performance-based metrics, accountability, and transparency in services and licensing supporting vulnerable populations through home- and community-based services and reducing waiting lists prevention services to support at-risk families improving food security while supporting agriculture Go here to … Read More

Posted in Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance, Pennsylvania proposed FY 2021 budget, Pennsylvania safety-net hospitals, Pennsylvania state budget issues, Safety-Net Association of Pennsylvania

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its January 2020 newsletter. Included in this month’s edition are articles about: the transition to a new Medicaid prescription drug list (PDL); the rollout of a new electronic visit verification system for Medicaid-paid home health services; and progress in the state’s effort to introduce major changes in its Medical Assistance transportation program (MATP). Read about these subjects and more in the Pennsylvania Health Law Project’s January 2020 newsletter.

Posted in Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance
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2012 Safety-Net Association of Pennsylvania