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Medicaid Enrollment on the Rise

More people are enrolling in Medicaid, and much of the increase is driven by the COVID-19 emergency. Or so reports the organization Families USA in a new study. According to the study, Over half of the 38 states reporting monthly enrollment through May or later have seen greater than 7% growth in enrollment since February. For the eight states reporting August enrollment, their average enrollment growth since February is approximately 11%. But the implications are even greater, according to the analysis, which found that in large part because of COVID-19 job loss, Medicaid enrollment among the 38 states reporting has already increased by 4.3 million people and is poised to increase much more in the near future. Analysis by Health … Read More

Posted in Coronavirus, COVID-19, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania safety-net hospitals

Eliminate Medicaid DSH Cut, SNAP Asks PA Delegation

A Continuing Resolution to fund the federal government in FY 2021 should eliminate a cut in federal Medicaid disproportionate share (Medicaid DSH) allotments to the states, and the Safety-Net Association of Pennsylvania has written to the state’s congressional delegation asking its members to convey this message to congressional leaders. The cut was mandated by the 2010 Affordable Care Act but has never been implemented. In its letter to the delegation, SNAP wrote that The Medicaid DSH cut was predicated on the expectation that the Affordable Care Act would greatly reduce the number of uninsured Americans, and while it has, millions remain uninsured, including nearly 700,000 Pennsylvanians – a number thought to be rising because of the job loss associated with … Read More

Posted in Affordable Care Act, Medicaid supplemental payments, Pennsylvania Medicaid, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania

CMS Provides Guidance on Medicaid DSH Calculations

State Medicaid program accounting for hospital uncompensated care when calculating hospital-specific Medicaid disproportionate share limits is the subject of new guidance from the Centers for Medicare & Medicaid Services. In the guidance, the Centers for Medicare & Medicaid Services explains that because of several court rulings, states can decide for themselves whether to offset third-party payer payments from costs in their Medicaid DSH calculations for periods prior to June 2, 2017 but that beginning with that date,  CMS will enforce its own interpretation of the policy. In new guidance, CMS presents two methodologies for accounting for its mid-year policy change and reminds stakeholders about its new methodology for calculations after June 2, 2017. Pennsylvania’s Department of Human Services and its … Read More

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

PA Health Law Project Newsletter

The Pennsylvania Health Law Project has published its August 2020 newsletter Health Law News. Included in this month’s edition are articles about: The Department of Human Services’ selection of new managed care plans to serve Pennsylvania Medicaid’s Community HealthChoices program. The end of ensured continuity of long-term services and supports for participants in the Community HealthChoices program in northeastern Pennsylvania. The availability of navigators to help connect people to COVID-19 testing and treatment. Read about these subjects and more in the Pennsylvania Health Law Project’s August 2020 newsletter.

Posted in HealthChoices, long-term care, Pennsylvania Medicaid, Pennsylvania Medicaid policy, Pennsylvania Medical Assistance

COVID-19 Update: March 27, 2020

The following is a summary of the major COVID-19-related developments in Pennsylvania as of 4:30 p.m. on March 27. Pennsylvania Updates Governor Wolf Today Governor Wolf expanded his ‘Stay at Home’ order to include nine more counties to mitigate the spread of the virus:  Berks, Butler, Lackawanna, Lancaster, Luzerne, Pike, Wayne, Westmoreland, and York counties.  The governor’s amended order, the secretary of health’s amended order, and the stay at home guidance are available online.  The order takes effect for these nine counties tonight at 8:00 p.m. and will continue for all of the affected counties until April 6. Today Governor Wolf approved and signed several bills into law to provide emergency relief to schools (SB 751), unemployment compensation rules (HB … Read More

Posted in Coronavirus, COVID-19, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19

COVID-19 Update: March 25, 2020

The following is a summary of the major COVID-19-related developments in Pennsylvania as of 5:15 on March 25. State Legislature Today the Senate passed House Bill 1232, as amended, which includes up to $50 million of additional funding to be made available for the state’s COVID-19 response efforts.  The legislation stipulates that funding shall only be used to buy medical equipment and supplies for health care entities to meet urgent patient and staff needs to address surge demand.  It also requires available federal funding and any funding made available through the governor’s disaster proclamation to be used before these funds.  The authority to transfer funds expires on September 30, 2020. Senate leadership noted that this is the first phase in … Read More

Posted in Coronavirus, COVID-19, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy

COVID-19 Update: March 20, 2020

The following is a summary of the major COVID-19-related developments in Pennsylvania today as of 5:30 p.m. on March 20, 2020. Pennsylvania Administration Since yesterday, the Department of Human Services has issued the following four new guidance documents: Billing Guidance for Alternative Screening Sites Related to COVID-19 Virtual Drop Ins Mental Health Revised Due Dates for Case Mix Index (CMI) Reporting, Cost Report Submissions, and Nursing Facility Assessment Payment Plan Requests Interim Guidance on Visitation in Nursing Facilities During COVID-19 We notified you last night that the governor issued an order to close all “non-life-sustaining businesses.” Below please find two resources for additional information. Any business that would like to seek a waiver to the mandate to close can send … Read More

Posted in Coronavirus, COVID-19, Federal Medicaid issues, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19, Pennsylvania Medicaid policy, Uncategorized

COVID-19 Update: March 19, 2020

The following is a summary of the major COVID-19-related developments in Pennsylvania for March 19, 2020 as of 6:30 p.m. Pennsylvania Administration Governor’s Order Closing State Businesses Early in the evening, Governor Tom Wolf announced that he was ordering the immediate closing of what he called “non-life-sustaining businesses in Pennsylvania.”  See his news release on the order here, the order itself here, and a list of types of businesses and whether they are or are not “life-sustaining” here. Pennsylvania Department of State Licensure Exceptions and Fast Track The Pennsylvania Department of State Bureau of Professional and Occupational Affairs, in conjunction with Governor Wolf, issued a press release announcing that the governor had granted the department’s request for a suspension to … Read More

Posted in Coronavirus, COVID-19, Federal Medicaid issues, Pennsylvania Department of Health and COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid coronavirus, Pennsylvania Medicaid COVID-19

COVID-19 Update: March 17, 2020

The following is a summary of the major COVID-19-related developments in Pennsylvania today. Telemedicine The Office of Medical Assistance Programs has issued guidance for providers on the use of telemedicine  services for Medicaid patients – those covered both by managed care plans and on a fee-for-service basis. Learn more from the newly posted telemedicine guidelines and a separate memo to the HealthChoices managed care plans from the state. In addition, CMS issued a waiver for certain restrictions on the provision of telemedicine services under the Medicare program.  The details of the wavier are described in a Fact Sheet and FAQ. New Guidance From the State Today the state published a number of COVID-19-related resources: ICD-10-CM Official Coding Guidelines Related to … Read More

Posted in Coronavirus, COVID-19, Pennsylvania Department of Health coronavirus, Pennsylvania Medicaid, Pennsylvania Medicaid laws and regulations, Pennsylvania Medicaid policy

PA Health Law Project Newsletter

The Pennsylvania Health Law Project has published its February 2020 newsletter Health Law News. Included in this month’s edition are articles about: Governor Wolf’s proposed FY 2021 Medicaid budget. Challenges Pennsylvania Medicaid recipients have encountered obtaining services from their HealthChoices managed care plan and how to address them. Implementation of the federal “public charge” regulation and whom it does – and does not – affect. Read about these subjects and more in the Pennsylvania Health Law Project’s February 2020 newsletter.

Posted in Federal Medicaid issues, HealthChoices, Pennsylvania Medicaid, Pennsylvania proposed FY 2021 budget
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2012 Safety-Net Association of Pennsylvania