Archive for Pennsylvania Medical Assistance
The Pennsylvania Health Law Project has published its March-April 2019 newsletter. Included in this month’s edition are articles about: The launch of a new tool to determine applicants’ eligibility for Medicaid-covered long-term services and supports. An update on Medicare Part D payment problems that affect some dually eligible Medicare/Medicaid patients. Highlights of the state’s Department of Human Services budget (including Medicaid). An update on the status of the Affordable Care Act. Go here for articles about these and other subjects.
The Pennsylvania Health Law Project has published the June 2018 edition of its monthly newsletter. Included in this edition are articles about: Changes in Pennsylvania Medicaid’s medical transportation program governing non-emergency transportation. The renewal of the state’s hospital tax and an increase in that tax. Challenges surrounding the implementation of Community HealthChoices, the state’s new program of managed long-term services and supports, in southwestern Pennsylvania. Information about the launch of Community HealthChoices in southeastern Pennsylvania. A provision in a recent bill modifying the state’s human services code that calls for the Department of Human Services to develop a new, outcomes-based program for hospitals and Medicaid managed care plans that will be oriented toward preventing potentially avoidable medical events. Find these … Read More
The Centers for Medicare & Medicaid Services had introduced a new “Medicaid scorecard” that the agency says it hopes will “…increase public transparency about the programs’ administration and outcomes.” The scorecard, now posted on the Medicaid web site, presents information and data from the federal government, and reported voluntarily by the states, in three areas: state health system performance, state administrative accountability, and federal administrative accountability. The scorecard currently offers information on selected health and program indicators. Visitors can see comparative data between states and also extensive information about individual state Medicaid programs, including eligibility criteria, enrollment, quality performance, and key state documents such as state plan amendments, waivers, and managed care program overviews. The site also presents individual state … Read More
The Pennsylvania Department of Human Services has issued a new Medical Assistance Bulletin titled “Hospital Responsibilities Related to the Uncompensated Care Program and Charity Care Plans.” According to the document, The purpose of this Medical Assistance (MA) Bulletin is to remind hospitals of the requirements for the Hospital Uncompensated Care Program (Program) and reinforce the responsibility of hospitals to actively engage patients when determining eligibility for the Program. See the entire Bulletin here.
Leesa Allen, deputy secretary of the Pennsylvania Department of Human Services’ Office of Medical Assistance Programs and state Medicaid director, has been appointed to the board of directors of the National Association of Medicaid Directors. See the Wolf administration’s news release about Ms. Allen’s appointment here.
On Tuesday Pennsylvania Governor Tom Wolf unveiled his proposed FY 2018 budget to the state’s General Assembly. This budget proposal includes a number of provisions with potential implications for Pennsylvania’s safety-net hospitals. The Safety-Net Association of Pennsylvania has prepared a detailed review of those provisions. Officials of safety-net hospitals who would like to receive a copy of this memo may request one by using the “contact us” link on the upper right-hand corner of this screen. Find a news release from the governor’s office that outlines the proposed budget here and go here (scroll to the bottom of the screen) for links to budget overviews, the entire budget itself, the Wolf administration’s presentation on its plan to consolidate Pennsylvania’s Department of … Read More
Pennsylvania’s Medicaid program has announced plans to launch a new hospital quality incentive program that will focus on measuring preventable hospital admissions and will reward hospitals that improve their performance. The program, part of a larger effort by the state to move away from volume-driven Medicaid payments and toward a greater focus on value and population health, will measure and reward incremental improvement in reducing preventable admissions and achieving the 25th or 50th percentile benchmark of a state-wide preventable event rate. Hospitals that meet their objectives will qualify for bonus payments from the state funded by proceeds from Pennsylvania’s state-wide hospital assessment. HealthChoices, Pennsylvania’s Medicaid managed care program, seeks to purchase 7.5 percent of Medicaid services through value-based purchasing arrangements … Read More
The cost of treating Medicaid patients who suffer from hepatitis C is posing a challenge to Pennsylvania’s Medicaid program. As new, more expensive, but more effective hepatitis C drugs reach the market, the state’s costs for treating Medicaid patients with the disease have doubled since 2013. Meanwhile, the state continues to consider at what point in the progression of their hepatitis C Medicaid patients should be offered the most expensive drugs. Current guidelines are evolving both in the state and nationally, with medical authorities and federal regulators weighing in with their views. Recently, an advisory committee to the Pennsylvania Department of Human Services offered its own recommendations for criteria for prescribing the most expensive drugs. Learn more about the issue, … Read More
The Pennsylvania Health Law Project has published the April 2016 edition of Health Law News, its monthly newsletter. Included in this edition are articles about a new, faster process the state has introduced for people to enroll in Medicaid; the awarding of contracts to managed care organizations to participate in the state’s HealthChoices program; an update on the Community HealthChoices program that will help nursing home-eligible seniors remain independent in the community; new funding for the state’s “Money Follows the Person” demonstration program; and more. Find the latest edition of Health Law News here.
The Pennsylvania Department of Human Services has launched a new online portal to facilitate provider enrollment in the state’s Medicaid program. According to DHS officials, the new portal will enable the state to enroll providers electronically and automate the provider enrollment process. Under the new approach, documents previously transmitted by mail or fax will be uploaded to the portal, providers will be able to view the status of their application, and the time needed to review and process provider applications will be reduced. Learn more about the new Medicaid provider portal from this state news release.