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Archive for Pennsylvania Medicaid policy

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

PA Says No to Medicaid Block Grants

Pennsylvania is not interested in pursuing the new Medicaid block grants being offered by the administration, leading state officials said last week. In a news release, Governor Wolf said that I expanded Medicaid in Pennsylvania to allow for more than 700,000 people to have reliable health care access. Pennsylvania will not go backwards. I will not risk jeopardizing our progress by going along with another short-sighted, insensitive plan to cut Medicaid… Department of Human Services Secretary Teresa Miller, who oversees the Pennsylvania Medicaid program that serves approximately 2.8 million people, echoed this sentiment: Changing any part of Medicaid to a block grant structure is the federal government permitting states to grow health inequities experienced by the poorest Americans. This cruel … Read More

Posted in Federal Medicaid issues, Pennsylvania Medicaid, Pennsylvania Medicaid policy

Medicaid Transportation Program Defies Fixing

Pennsylvania is trying to fix its Medical Assistance Transportation Program – but that is proving harder than proponents of change envisioned. For years, county governments ran their own programs, which provided free non-emergency transportation to doctor offices for Medicaid patients.  About 55,000 Pennsylvanians served by Medicaid use this program. But with a growing trend among states of dividing a state into regions and awarding regional contracts to transportation brokers and amid objections from county governments, the General Assembly directed the state’s departments of Aging, Human Services, and Transportation to look into the matter. And in the report those departments filed with the legislature, they say they do not know what to do. Learn more about the challenges facing the Medical … Read More

Posted in Pennsylvania Medicaid policy, Pennsylvania Medical Assistance

PA Introduces Medicaid PDL on January 1

Beginning tomorrow, Pennsylvania will employ a preferred drug list for its Medicaid program – a list that applies to both fee-for-service and managed care patients. And as many as 150,000 of the state’s 2.8 million Medicaid beneficiaries may find themselves facing changes in their prescription drugs. The purpose of the PDL is to save money – an estimated $85 million a year, according to the Pennsylvania Department of Human Services. While physicians may submit requests to the state for exemptions for specific patients for specific purposes, those exemptions may be relatively uncommon:  the managed care plans that serve the vast majority of the state’s Medicaid population face daily fines starting at $1000 a day if their adherence to the new … Read More

Posted in Pennsylvania Medicaid policy

PA Health Law Project Newsletter

The Pennsylvania Health Law Project has published its November-December 2019 newsletter. Included in this month’s edition are articles about: Changes in care coordination in the Community HealthChoices program in southeastern Pennsylvania beginning on January 1. Changes in the delivery of Medicaid-covered intensive behavioral health services in homes, schools, and the community for children and adolescents. The switch from Medicaid to Medicare as primary payer for medication-assisted treatment for opioid use disorder for dually eligible (Medicare and Medicaid) patients. Pennsylvania’s request for a delay in implementation of electronic visit verification for Medicaid-covered personal assistance services and home health aides. The delay in implementation of the new public charge rule and its implications for taking advantage of Medicaid benefits among potentially affected … Read More

Posted in Pennsylvania Medicaid, Pennsylvania Medicaid policy

DHS Unveils Strategic Plan

Pennsylvania’s Department of Human Services has a new strategic plan for 2019 through 2022. While DHS’s area of endeavor is broad and goes beyond health care, Medicaid is an important aspect of its work and that importance is reflected in the plan, which includes descriptions of DHS’s ambitions in the following areas: Provide every child with a strong foundation for physical and behavioral well-being Bend the health care cost curve Drive innovative whole-person care Holistically assess needs and connect to resources Address the social determinants of health Expand health care beyond the doctor’s office and into the places people live, work, and play Coordinate physical health care, behavioral health care, and long-term services and supports Promote health equity Lead the … Read More

Posted in Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance

PA Health Law Project Newsletter

The Pennsylvania Health Law Project has published its October 2019 newsletter. Included in this month’s edition are articles about: the state’s release of a request for applications for insurers to serve participants in Pennsylvania’s HealthChoices physical health care program Pennsylvania’s new Medicaid preferred drug list legislation to expand the state’s Medical Assistance for Workers Program the expansion of the state’s Living Independence for the Elderly (LIFE) program to 14 new counties over the next 18 months. Read about these subjects and more in the Pennsylvania Health Law Project’s October newsletter.

Posted in HealthChoices, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance

PA to Help Medicaid Beneficiaries Who Want to Work

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

Posted in Pennsylvania Medicaid, Pennsylvania Medicaid policy

MA Bulletin Presents New PDL

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.

Posted in Medical Assistance Bulletin, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy
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