During the week of November 4, 2019, six U.S. senators re-introduced bipartisan legislation, the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, to improve health outcomes, make it easier for patients to connect with physicians, as well as help cut costs for patients and providers by eliminating barriers to the use of telehealth services for Medicare beneficiaries. It would: provide the Secretary of Health and Human Services with the authority to waive telehealth restrictions when necessary; remove geographic and originating site restrictions for services; allow rural health clinics and federally qualified health centers to provide telehealth services; and require a study to explore ways to expand telehealth so people could access healthcare in their homes. The legislation has been endorsed by more than 120 organizations such as the American Hospital Association, the Healthcare Information and Management Systems Society, and the National Association of Community Health Centers. Companion legislation has been introduced in the House of Representative. Read more.

On October 28, 2019, the Pennsylvania Department of Human Services (DHS) released a preliminary report that reviews financial data, studies, and surveys related to the Medical Assistance Transportation Program (MATP) and non-emergency medical transportation brokerage programs. Per a legislative directive, DHS developed a MATP Analysis Workgroup to study the state’s shift to a brokerage model. The report outlines the data sources used as the foundation of the analysis and how the workgroup is seeking stakeholder feedback. The final analysis is scheduled for completion by December 28.

The Pennsylvania departments of Human Services (DHS) and Corrections (DOC) today announced that all of DOC’s state-run correctional facilities are connected to DHS’ Pennsylvania Patient & Provider Network (P3N). This marks a significant milestone in the commonwealth’s ability to help individuals to maintain continuity of their medical care before, during and after incarceration in a Pennsylvania state prison.

“DOC’s connection to the P3N will have a positive impact on health care for incarcerated and returning citizens by enabling the electronic sharing of information with thousands of health care providers connected to the five existing P3N certified Health Information Organizations (HIO) in Pennsylvania,” said DHS Secretary Teresa Miller. “This will bridge connections between care received while incarcerated to help returning citizens on their paths to healthy and productive lives.”

“Our charge every single day is to provide our inmate population with health care services that meet or exceed community standards,” said DOC Deputy Secretary for Administration Christopher Oppman. “Having immediate access to past medical records gives us the ability to provide timely, comprehensive care, which benefits the inmate and his/her health.  Similarly, being able to provide critical information to outside health care providers upon release also ensures continuity of health care services and successful reentry back into the community.”

When an individual first enters an SCI, that facility will access that person’s medical data via the P3N to review the treatments and services they received from health care providers prior to their incarceration. This will give the correctional facility a better picture of a new inmate’s clinical history so that they can provide appropriate follow-up care while the person resides in that SCI.

Health care providers who are treating and caring for reentrants are also able to access vital information that providers should know when making clinical decisions. P3N network participants across the commonwealth will be able to access DOC’s patient information about treatments and services that individuals received during their periods of incarceration in a state correctional institution (SCI).

In addition to maintaining continuity of care, this bi-directional information exchange between DOC and the P3N also reduces the amount of time needed to access vital patient data and lowers costs by reducing duplicative tests and services.

Through this partnership with DHS, the DOC’s connection to the P3N gives SCI medical personnel the data needed to treat and serve new inmates. In addition, community health providers can better serve reentrants who have become their patients, helping them to achieve better health outcomes.

The P3N was established through Act 76 of 2016 to create a means of communication between health care providers, payers and patients. It creates efficiencies in health care delivery and promotes improved health outcomes for patients. The P3N links health information organization (HIO) member organizations to providers and payers across the state improving health care in their communities through increased coordination and communication between providers.

In July, Governor Tom Wolf signed an executive order strengthening protections for vulnerable populations such as re-entering citizens. As part of this effort, the administration is committed to supporting innovation in work and information sharing between agencies and our partners in the private sector. This expanded network of information sharing will help health care providers working in the SCIs and communities have more complete pictures of reentering citizens’ medical histories and do more to address their needs and barriers to good health.

For more information on the Department of Human Services, visit www.dhs.pa.gov.

For more information on the Department of Corrections, visit www.doc.pa.gov.

The Pennsylvania Department of Transportation (PennDOT) has published its Statewide Active Transportation Plan and is seeking public input. The plan identifies and prioritizes strategies that will promote more opportunities for bicyclists and pedestrians and promotes health and wellness activities that support objectives in the State Health Improvement Plan, especially strategies in the obesity, physical activity and nutrition focus.  The plan includes information on developing and improving infrastructure that will support bicycling and pedestrian projects and enhance economic initiatives in rural and urban communities.

Public input is due by December 6, 2019 and should be submitted to ra-pdbikepedmsterpln@pa.gov.

On November 1, CMS finalized updates to the Medicare Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Care Center (ASC) Payment System for the 2020 calendar year. In addition to updating payment rates, this rule finalizes completing the two-year phase-in of site neutral payment for clinic visits when provided at an off-campus provider-based department. This final rule also finalizes to pay Average Sale Price (ASP) minus 22.5 percent for 340B-acquired drugs for CY 2020. Rural sole community hospitals are still exempted from the reduction and will continue to be paid ASP plus 6 percent. In the rule, CMS finalizes a change to the generally applicable minimum required level of supervision for hospital outpatient therapeutic services furnished by all hospitals and Critical Access Hospitals (CAHs) from direct supervision to general supervision. CMS is also finalizing for the OPPS, the other wage index policies adopted in the FY 2020 IPPS final rule. CMS plans to finalize these provisions on price transparency and requirements for making public a list of standard charges in a standalone document at a later date. As part of this rulemaking, CMS is accepting comments on the payment classifications assigned to the interim APC assignments and/or status indicators of new or replacement Level II HCPCS codes until 5 pm EST on December 2, 2019.  Click here for more information from the Federal Register.

On November 1, CMS issued a final rule that includes updates to payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) effective on or after January 1, 2020. This includes three new telehealth codes to describe a bundled episode of care for treatment of opioid use disorders, Medicare coverage for opioid treatment programs, updates to care management services, implementation of a ground ambulance data collection system, and a revision to the current supervision requirement to clarify physician supervision requirements for physician assistants (PAs), among other updates. The rule also makes updates to Medicare’s Quality Payment Program including performance thresholds and category weights for the 2020 performance period and clarifying the definition of rural for the purposes of the Merit-Based Incentive Payment System (MIPS). As part of this rulemaking, CMS included an interim final rule with comment period (IFC) to establish coding and payment for evaluation and management, observation and the provision of self-administered Esketamine, with comments on that proposal due no later than 5 pm on December 31, 2019.  Click here for more information from the Federal Register.

CMS requires that all Critical Access Hospitals (CAHs) use either the 2014 or 2015 Edition certified electronic health record technology (CEHRT) to meet the reporting requirements of the Medicare Promoting Interoperability Program and successfully demonstrate meaningful use.  Downward payment adjustments must be applied to CAHs that are not meaningful users of CEHRT.  However, CAHs may avoid the Medicare downward payment adjustments by completing a hardship exception application by December 2 to show that meeting the meaningful EHR user requirements would result in a significant hardship.  Click here for more information.