The Pennsylvania Department of Human Services (DHS) on August 26 posted Medical Assistance fee schedule changes that become effective Sept. 5. DHS is adding and end-dating procedure codes according to the 2023 updates provided by the Centers for Medicare and Medicaid Services to the Healthcare Common Procedure Coding System (HCPCS). DHS is adding procedure codes and setting limitations and making fee adjustments to current procedure codes.

A group of Philly 30-somethings raised funding to buy more than $1.6 million in local medical debt. They celebrated with an unofficial debt burning, complete with lighter fluid, shots, Roman candles, and sparklers. More than 1,700 beneficiaries are slated to receive letters informing them that someone took care of part or all their medical debt starting mid-September.

The Centers for Medicare and Medicaid Services (CMS) issued draft guidance to allow people with Medicare to pay out-of-pocket prescription drug costs in monthly payments. The New Medicare Prescription Payment Plan will help people pay Medicare Part D costs over the year instead of all at once. The draft guidance provides information on topics such as identifying Medicare Part D enrollees likely to benefit from the program, the opt-in process for Part D enrollees, program participant protections, and the data collection needed to evaluate the program. The draft guidance solicits comments on these topics and on strategies to help ensure eligible Part D enrollees benefit from programs like the Medicare Savings Program and Extra Help to lower their out-of-pocket prescription drug costs. The comment period is open until September 20, 2023.

Nationwide, millions of Medicaid beneficiaries are being disenrolled with many losing coverage because of missing or incorrect paperwork. Nearly 5.5 million people nationally are believed to have been disenrolled with at least 1 million of those being children. The Center for Children and Families at Georgetown University estimates that nearly half of people disenrolled still meet the eligibility criteria. In Pennsylvania, Medicaid enrollment has declined by 3% or 111,646 beneficiaries since April. Of the 3,596,759 enrollees, 2,172,041, or 60% are adults, and 1,424,718, or 40% are children. To review more data reporting information, access the DHS Federal Unwinding Report Dashboard.

U.S. Rep. Dan Meuser, R-09, co-sponsored H.R. 1310 — the States Handling Access to Reciprocity for Employment (SHARE) Act — which will improve patient care and address workforce shortages that are causing a considerable strain on the healthcare system, particularly in rural communities. Current law requires healthcare providers to obtain a license or certification from each state in which they wish to practice. If a provider, such as a doctor or nurse, licensed in one state relocates to another, that provider must complete the licensure process again for each new state in which they wish to practice. This process is burdensome and strips providers of the ability to practice in any new state until the application is approved — sometimes taking more than half a year. The SHARE Act will make a technical correction to modernize a vital component of the licensure process for healthcare providers seeking a license under an interstate compact. Specifically, the legislation removes red tape and reduces administrative burdens by authorizing the FBI to share criminal history record information between states for licensure purposes. This will allow background checks to be completed in a much more efficient and timely manner, which is often one of the longest aspects of the license application process.

The Rural Health Value team recently updated Demonstrating Your Value: A Guide to Potential Value-based Care Partnerships for Rural Health Care Organizations. This resource can help rural healthcare leaders demonstrate the value their organizations can bring to networks, affiliations, payers, systems, or accountable care organizations (ACOs). The Rural Health Value team also updated its Catalog of Value-Based Initiatives for Rural Providers, as one-page summaries describing rural-relevant, value-based programs. The Rural Health Value team is funded by the Federal Office of Rural Health Policy.