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SNAP Joins Letter Urging Preservation of Tobacco Funding

The Safety-Net Association of Pennsylvania has joined 10 other organizations in urging Pennsylvania’s General Assembly to use 100 percent of Tobacco Settlement Fund monies for health-related services and programs in the coming fiscal year. For FY 2018-2019, Pennsylvania borrowed against future proceeds from the Tobacco Settlement Fund to help balance the state budget.  Debt service payments will soon be due and the Wolf administration has proposed paying that debt service with proceeds from the state’s sales and use taxes.  In a letter to state legislators, SNAP and the others endorse this aspect of the administration’s proposed budget FY 2019-2020 budget. Tobacco fund proceeds are vital to Pennsylvania’s safety-net hospitals, helping to compensate them for some of the care they provide … Read More

Posted in Medicaid supplemental payments, Pennsylvania proposed FY 2020 budget, Pennsylvania safety-net hospitals

New Poverty Level Standards to Jeopardize Medicaid Eligibility?

The Trump administration is considering changing how the federal government measures inflation for the purpose of calculating the federal poverty level. Such a change, if implemented, could potentially reduce inflation-related increases in the federal poverty level, which in turn could limit the ability of some individuals and families to qualify, or continue to qualify, for a variety of public safety-net services – including, potentially, Medicaid. Among the possible alternatives to the current methodology for calculating inflation is the Chained Consumer Price Index for All Urban Consumers.  The Obama administration also explored substituting this index for the current inflation factor. Any change that makes it more difficult for people to qualify for Medicaid could be particularly damaging to Pennsylvania safety-net hospitals, … Read More

Posted in Federal Medicaid issues, Pennsylvania safety-net hospitals

Senate Finance Committee Reports on Supplemental Medicaid Payments

The majority members of the Senate Finance Committee have published a report on supplemental Medicaid payments. According to the new document, This report seeks to increase educational understanding of Medicaid supplemental payments, as well as outline the reporting mechanisms for these payments to ensure adequate stewardship of taxpayer dollars.  The report consists of descriptions of the different types of supplemental Medicaid payments that states make to some providers, including: Medicaid disproportionate share payments (Medicaid DSH) non-DSH payments upper-payment limit payments (UPL payments) demonstration supplemental payments medical education payments It also describes the magnitude of these payments, noting that supplemental Medicaid payments accounted for $50 billion of the $600 billion spent on Medicaid by the federal and state governments in 2016, … Read More

Posted in DSH hospitals, Medicaid supplemental payments, Pennsylvania safety-net hospitals

Uninsured ED and Inpatient Visits Down Since ACA

Uninsured hospital admissions and emergency department visits are down since passage of the Affordable Care Act. And Medicaid-covered admissions and ER visits are up, according to a new analysis. The report, published on the JAMA Network Open, found that ER visits by uninsured patients fell from 16 percent to eight percent between 2006 and 2016, with most of this decline after 2014, while uninsured discharges fell from six percent to four percent. The rate of uninsured ER visits declined, moreover, at a time when overall ER visits continued to rise. While the Affordable Care Act is likely the cause of most of these changes, other contributing factors include the emergence of urgent care facilities, telemedicine, and free-standing ERs as well … Read More

Posted in Affordable Care Act, Pennsylvania Medicaid, Pennsylvania safety-net hospitals

SNAP Asks Congress for Help on Medicaid DSH

Prevent Medicaid DSH cuts:  that is the message the Safety-Net Association of Pennsylvania conveyed to Pennsylvania’s congressional delegation this week. In a message sent to every member of the U.S. House of Representatives from Pennsylvania, SNAP asked members to sign onto a letter to House Speaker Nancy Pelosi asking her to delay Affordable Care Act-mandated cuts in Medicaid disproportionate share payments (Medicaid DSH) that are scheduled to take effect in October of this year. If implemented, the cut would hurt 179 of Pennsylvania’s 213 hospitals, including all safety-net hospitals, and cost the state approximately $240 million in Medicaid DSH revenue in FY 2020 and $480 million a year in FYs 2021 through 2025. See the letter requesting action on Medicaid … Read More

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

SNAP Endorses Governor’s Proposal for Paying for Tobacco Borrowing

Debt service on the state’s borrowing against future proceeds from the national master tobacco settlement agreement should be paid using state sales and use tax revenue, SNAP has declared in a new position statement. Last year the state borrowed $1.5 billion against future proceeds from the tobacco settlement.  Some tobacco settlement money is used to help hospitals with the cost of uncompensated care they provide via tobacco uncompensated care payments and tobacco extraordinary expense payments made to hospitals that meet specific criteria:  how much uncompensated care they provide, the proportion of their patients insured by Medicaid, and the proportion of low-income seniors they serve.  All Pennsylvania safety-net hospitals qualify for these payments. Because the state’s borrowing against future tobacco settlement … Read More

Posted in Medicaid supplemental payments, Pennsylvania Medicaid policy, Pennsylvania proposed FY 2020 budget, Pennsylvania safety-net hospitals, Pennsylvania state budget issues

Delay Medicaid DSH Cut, Pelosi Says

Medicaid DSH cuts should be delayed, House Speaker Nancy Pelosi (D-CA) told a gathering of hospital officials. According to Speaker Pelosi, DSH cuts threaten to erode the health of community hospitals, safety-net hospitals and rural hospitals, [affecting] the health of not only the families that rely on Medicaid, but any person who relies on these hospitals for care. SNAP members all receive Medicaid DSH payments and would be harmed if the scheduled cut takes effect on October 1. Learn more about Speaker Pelosi’s remarks in the Becker’s Hospital Review article “House speaker urges Congress to ease Medicaid payment cuts to hospitals serving low-income patients.”

Posted in DSH hospitals, Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania safety-net hospitals

Medicare Advantage Permitted to Address Non-medical Needs

Starting in 2020, Medicare Advantage plans will be permitted to provide non-medical benefits to their chronically ill members. As described in the Centers for Medicare & Medicaid Services’ “final call letter’ for 2020, MA [Medicare Advantage] plans are not prohibited from offering an item or service that can be expected to improve or maintain the health or overall function of an enrollee only while the enrollee is using it.  In other words, the statute does not require that the maintenance or improvement expected from an SSBCI [special supplemental benefits for the chronically ill] result in a permanent change in an enrollee’s condition.  Items and services may include, but are not limited to:  meals furnished to the enrollee beyond a limited … Read More

Posted in Medicare, Pennsylvania safety-net hospitals, social determinants of health

Groups Work to Create New Codes for Social Determinants

Social determinants of health could have their own ICD-10 codes if a new initiative from the American Medical Association and United Healthcare succeeds. The two are working together to develop new ICD-10 codes that would take into consideration social determinants of health such as housing and food security, access to transportation, and ability to pay for medicine. The project launches at a time when research suggests that social determinants of health can affect nearly 80 percent of health care outcomes. Pennsylvania safety-net hospitals struggle more than other hospitals, and must work harder to address, the social determinants of health that play such a major role in the health and well-being of the residents of the low-income communities they serve. Learn … Read More

Posted in Pennsylvania safety-net hospitals, social determinants of health

Bill Would Enable Foreign-Born Docs to Work in Underserved U.S. Areas

More foreign-born, U.S.-trained doctors would be permitted to remain in the U.S. if they practice in medically underserved areas under a bill unveiled last week in Congress. Introduced with bipartisan support, the legislation would extend for two years the current “Conrad 30” program that allocates 30 slots to each state so foreign-born doctors can work in medically underserved areas under J-1 visas.  The program, which already exists but will soon expire, permits such physicians to remain in the U.S. for three years after their training ends to work in underserved areas.  The legislation also would establish criteria under which more than 30 such physicians can be employed in a given state. Some Pennsylvania safety-net hospitals are located in and around … Read More

Posted in Pennsylvania safety-net hospitals
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