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PA Health Law Project Newsletter

The Pennsylvania Health Law Project has published its May 2018 newsletter. Included in this month’s edition are stories about: The continued implementation of Community HealthChoices, the state’s new program of managed long-term services and supports for dually eligible Medicaid and Medicare beneficiaries. The introduction of a new tool for determining whether Medicaid beneficiaries shall be deemed eligible for Medicaid long-term-care services. State legislation that, if adopted, would establish presumptive eligibility for older adults applying for in-home care. A new framework for participants in state Medicaid managed care programs to appeal denials of services. New processes to streamline the determination of eligibility for Medicaid of individuals recently released from prison. Pending legislation that would permit selected mental health facilities to deem … Read More

Posted in HealthChoices, long-term care, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy

PA Health Law Project Newsletter

The Pennsylvania Health Law Project has published its April 2016 newsletter. Included in this edition are stories about: the continued introduction in southwestern Pennsylvania of the Community HealthChoices program of managed long-term services and support for seniors and the planned implementation of the program in southeastern Pennsylvania; a court ruling invalidating the state’s selection of managed care plans to serve Medicaid recipients who participate in the HealthChoices physical health program; and legislative efforts to establish a work requirement for some Medicaid participants. Go here for the latest edition of PA Health Law News.  

Posted in HealthChoices, Pennsylvania Medicaid

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has just published the March 2018 edition of its monthly newsletter. Included in this edition are articles about: new procedures that will make it easier for Medicaid recipients to be treated for opioid abuse the continued implementation of the Community HealthChoices program of managed long-term services and supports for nursing home-eligible seniors, including its introduction in southeastern Pennsylvania beginning next year the work of special needs units in the HealthChoices managed care plans the confirmation of Teresa Miller as Secretary of the Pennsylvania Department of Human Services Find these stories and others here, in the latest edition of the Pennsylvania Health Law Project’s newsletter.  

Posted in HealthChoices, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its latest Health Law News. Included in the November edition are articles about: a proposal to impose a work requirement on Pennsylvania Medicaid recipients the CHIP program leadership changes in health care-related state agencies the rollout of the Community HealthChoices program of managed long-term services and supports HealthChoices managed care contracts changes in several state waiver programs Find these stories here in the latest edition of Health Law News.

Posted in HealthChoices, Pennsylvania Medicaid, Pennsylvania Medicaid policy

CMS Guidance on MCO Payments is Good News for PA Hospitals

New guidance from the Centers for Medicare & Medicaid Services on the use of directing additional Medicaid resources to hospitals through Medicaid managed care organizations is good news for Pennsylvania safety-net hospitals. Such payments have been routed through the state’s Medicaid managed care plans for several years, but as the state and hospital industry continue negotiating renewal of the state’s hospital tax – its “Quality Care Assessment” – it was not entirely clear whether the federal government would permit continued use of this mechanism. An early November bulletin from CMS, however, clarifies that this approach is still permissible, which is good news for Pennsylvania safety-net hospitals and SNAP members hoping to benefit from the state’s hospital assessment. Go here to … Read More

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

Pennsylvania Health Law Project Newsletter

The Pennsylvania Health Law Project has published its March 2017 newsletter. Included in this edition are stories about: new starting dates for the beginning of new HealthChoices physical health contracts an update on Community HealthChoices, the state’s planned program of managed long-term services and supports for those who qualify for nursing home care but wish to continue living independently in the community the launch of the state’s ABLE Savings Program through which children and adults with significant disabilities can open special state-sponsored investment accounts the introduction of a new assessment tool for people in need of substance disorder treatment Find the latest edition of PA Health Law News here.

Posted in HealthChoices, Pennsylvania Medicaid, Pennsylvania Medicaid policy

Presentation on Value-Based Purchasing in PA Medicaid

Pennsylvania’s Medicaid program is moving toward greater use of value-based purchasing in its Medicaid behavioral health programs. Last week, the state’s Office of Mental Health and Substance Abuse Services held a webinar to offer information about the state’s plan for employing value-based purchasing in Medicaid and how it will do so for behavioral health services in particular.  Go here to see the presentation delivered at that webinar.  

Posted in HealthChoices, Pennsylvania Medicaid policy

New HealthChoices Contracts Delayed

Pennsylvania’s plan to implement new contracts with HealthChoices physical health managed care plans on June 1 has been put on hold. The reason:  for the second time, companies that lost a public bidding process protested the state’s choices.  The first time, the state threw out all the bids and started over again.  This time the state says it needs more time to deal with the protests, negotiate new contracts, and get the new contractors up and running. In addition to the delay, the new contracts will be phased in at different times in different parts of the state, with the first regional launch now scheduled for January of 2018 and the last a year later. Learn more about why the … Read More

Posted in HealthChoices

Controversy Continues Over HealthChoices Awards

Pennsylvania appears to be no closer to awarding new contracts to serve its HealthChoices Medicaid physical health program than it was when it first launched the process of soliciting bids for such contracts in September of 2015. When losing bidders protested the contracts awarded based on the state’s original request for proposals and took the state to court, the state threw out all the bids and cast aside its decision and started the process all over again, issuing a new request for proposals last year.  When the state announced new awards in January the losing bidders again protested, this time alleging “irregularities” in the decision-making process.  With the renewed threat of litigation, the planned implementation of the new contracts on … Read More

Posted in HealthChoices
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2012 Safety-Net Association of Pennsylvania