Archive for Safety-Net Association of Pennsylvania

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

SNAP Writes to House Ways and Means Committee About Medicaid DSH Audits

The federal government should give states the option of monitoring Medicaid disproportionate share payments (Medicaid DSH) to hospitals through prospective DSH limit calculations rather than through retroactive DSH audits. SNAP recently shared this view with the House Ways and Means Committee’s Health Subcommittee in response to that subcommittee’s request for suggestions from stakeholders on ways to improve the delivery of Medicare services and eliminate statutory and regulatory obstacles to more effective care delivery.  According to SNAP, retroactive DSH audits are cumbersome, burdensome, and expensive, give rise to many disputes and appeals, and in the end yield results very similar to much simpler prospective DSH limit calculations performed by the very state governments that distribute Medicaid DSH funds.  See SNAP’s comments … Read More

Posted in Federal Medicaid issues, Medicaid supplemental payments, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania, Uncategorized

SNAP Joins Others in Letter to PA Senators

SNAP was among 27 Pennsylvania health care organizations to send a joint letter to senators Bob Casey and Pat Toomey pointing out aspects of the House-passed American Health Care Act that could jeopardize access to care for medically vulnerable Pennsylvanians. Among the issues addressed in the letter are how the House-passed proposal would detract from the role of Medicaid in fighting the state’s opioid crisis; the proposed reduction in tax credits to help purchase health insurance; the challenge posed by a per capita approach to Medicaid financing; the potential loss of health care jobs; the likelihood of large numbers of Pennsylvanians losing their health insurance and state Medicaid costs rising significantly; and the erosion of consumer protections. See the complete … Read More

Posted in American Health Care Act, Federal Medicaid issues, Pennsylvania Medicaid, Pennsylvania safety-net hospitals, Safety-Net Association of Pennsylvania

SNAP, Other Groups Caution PA Delegation About Health Reform Bill

The Safety-Net Association of Pennsylvania has joined 13 other groups in writing to members of the state’s congressional delegation to warn about shortcomings in the American Health Care Act, health care reform legislation currently being considered by the U.S. House of Representatives. The letter warns that the American Health Care Act would “…dramatically reduce Medicaid coverage and strain resources for this critical program.” Read that letter here, on SNAP’s web site.

Posted in American Health Care Act, Safety-Net Association of Pennsylvania

SNAP Comments on Proposed Medicaid DSH Regulation

The Safety-Net Association of Pennsylvania has written to the Centers for Medicare & Medicaid Services to object to how the agency proposes changing its methodology for calculating eligible hospitals’ Medicaid disproportionate share (Medicaid DSH) payments. In particular, SNAP opposes the manner in which CMS would treat payments from Medicare and third-party payers made on behalf of Medicaid-eligible individuals. In SNAP’s view, the letter notes, …the hospital-specific DSH limit has come to penalize the very hospitals that Medicaid DSH payments were designed to support. The SNAP letter explains that What concerns SNAP at this time is CMS’s apparent decision to rationalize and codify in regulations a narrower interpretation of the Medicaid DSH limit than what Congress described in section 1923(g) of … Read More

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

CMS Unveils New Medicaid Managed Care Regulation

For the first time in more than 20 years, the federal government is introducing major changes in how it regulates Medicaid managed care. The Centers for Medicare & Medicaid Services describes the 1425-page rule as aligning Medicaid managed care with other health insurance programs, updating how states purchase managed care services, and improving beneficiaries’ experience with Medicaid managed care. To learn more about what CMS has proposed, go here to see the rule itself. Go here to see CMS’s news release accompanying the new regulation. Go here to (under the link “final rule”) to find nine fact sheets summarizing key aspects of the new regulation. And go here for a commentary on the new rule and the context in which it was released by CMS acting administrator Andy … Read More

Posted in Safety-Net Association of Pennsylvania

IOM Weighs in on Social Determinants Training

If patients’ symptoms and conditions are the product of who they are, where they are from, and how they have lived, can better understanding those circumstances help providers serve those patients more effectively? Increasingly the answer to that question has been yes, it can, and now, the National Academies of Science, Engineering, and Medicine and the Institute of Medicine have proposed an approach to training caregivers on the social determinants of health. Their new publication, A Framework for Educating Health Professionals to Address the Social Determinants of Health, notes that The World Health Organization (WHO) defines social determinants of health as “the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping … Read More

Posted in Safety-Net Association of Pennsylvania, Uncategorized

Governor Proposes FY 2017 Medicaid Budget

On Tuesday, February 9, Pennsylvania Governor Tom Wolf presented his proposed FY 2017 budget to the state legislature. That budget proposal calls for changes in some current Medicaid spending, including reductions of some supplemental payments and the elimination of others, as well as changes in funding the state’s share of Medicaid and the rate at which the federal government will match Pennsylvania’s own spending on Medicaid in the coming year. In addition, the budget calls for new and increased spending in selected areas within the purview of the state’s Department of Human Services and Health Department. SNAP has prepared a detailed memo outlining the potential implications of the proposed FY 2017 budget for safety-net hospitals. The memo also addresses the complications … Read More

Posted in Pennsylvania proposed FY 2017 budget, Pennsylvania state budget issues, Proposed FY 2017 Pennsylvania state budget, Safety-Net Association of Pennsylvania

Feds OK Medicaid Money for Housing

The Obama administration has informed state Medicaid programs that they may use federal Medicaid money to help the chronically homeless obtain housing. While a June bulletin to state Medicaid directors technically only clarified existing policy, it signaled states that the administration will be receptive to Medicaid waivers that propose using Medicaid funding to help the homeless obtain housing. Increasingly, state Medicaid programs have been finding that helping the homeless with housing is a key to improving their physical and behavioral health and can offer later savings as the individuals who have received such assistance live more stable lives, especially as more homeless people qualify for Medicaid benefits in states that have expanded their Medicaid programs. The Safety-Net Association of Pennsylvania … Read More

Posted in Safety-Net Association of Pennsylvania

Study Looks at Social Determinants of Health

A new issue brief from the Kaiser Family Foundation looks at the social determinants of health and health outcomes. The issue brief “Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity” reports that Social determinants have a significant impact on health outcomes. Social determinants of health are “the structural determinants and conditions in which people are born, grow, live, work and age.” They include factors like socioeconomic status, education, the physical environment, employment, and social support networks, as well as access to health care (Figure 2). Based on a meta-analysis of nearly 50 studies, researchers found that social factors, including education, racial segregation, social supports, and poverty accounted for over a third of total deaths … Read More

Posted in Safety-Net Association of Pennsylvania, Uncategorized
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2012 Safety-Net Association of Pennsylvania