The online site is meant to help beneficiaries, provider organizations, and state-level Medicaid agencies better understand how individuals and families can renew coverage from Medicaid and the Children’s Health Insurance Program (CHIP) or find better options.  The outreach materials are tailored to reach different populations, including by state, for people in rural areas, and various racial and ethnic communities.  The site also explains key government actions taken to support Medicaid renewals and transitions, as many are losing coverage in the post-pandemic policy shift known as Unwinding.  See Events below for an upcoming learning opportunity on January 24.

Read the full article here.

In 2021, Congress established this Federal Communications Commission program to increase access to the internet through monthly discounts for service and one-time payments to purchase a laptop, desktop computer, or tablet.  Without additional funding from Congress, the program is projected to run out of money in April 2024.  Households currently enrolled in the program will receive a notice from their internet service provider about the end of the benefit.  The FCC is still accepting applications until midnight Eastern time on February 7, but enrollees must have their eligibility approved and sign up with an internet service provider before this deadline.  Households who have applied, been approved, and are receiving the monthly internet discount before February 8, 2024 will continue to receive their ACP benefit until funds run out, as long as the household remains enrolled in the program.

Read the full article here.

The PA Department of Health (DOH) issued Health Advisory 733, concerning Measles cases in PA. As of Jan. 5, 2024, there have been seven cases of measles diagnosed in the commonwealth since Dec. 6, 2023. Six of these cases were epidemiologically linked and from southeastern Pennsylvania. One case was in northcentral Pennsylvania and not epidemiologically linked to the other cases. The index case in the southeastern Pennsylvania outbreak acquired measles while traveling abroad and the remaining cases were exposed via healthcare or childcare settings. The northcentral Pennsylvania case was unrelated, and the illness was acquired while living abroad. All these cases were in unvaccinated individuals. Providers should have an increased suspicion for measles in patients who are not immune and present with a febrile rash illness and follow the proper recommendations for testing and infection control measures. DOH reminds providers to immediately report suspected cases of measles to local public health authorities or to the DOH at 877-PAHEALTH (877-724-3258).

According to a new report by the Pennsylvania Health Care Cost Containment Council (PHC4) in collaboration with The Hospital and Healthsystem Association of Pennsylvania (HAP), Pennsylvania’s hospitals lost $8.1 billion during the COVID-19 pandemic but continued to provide economic value to the state. Of the expenses and lost revenue reported, the largest expense was staffing, which amounted to $1.3 billion. The report also indicates that in fiscal year 2022, hospitals provided an economic value of $182 billion in spending, an increase of $39 billion from before the pandemic in fiscal year 2019. Read the report.

While officials and families continue to grapple with the drug crisis’s devastating effects, a new report has investigated which states are succeeding as far as rehabilitation efforts go. Pennsylvania was found to be among the top. Click here to learn more.

The state of Pennsylvania’s cost for health and human services has increased from $24.1 billion to $59.1 billion from 2006 to 2023. That is a 63% increase over the 17 years after adjusting for inflation. Health and human services have a significant role in the state’s budget, accounting for approximately 65% of the total general fund expenditures in 2023 according to a recent budget document released by the commonwealth. The state attributed the increase in costs to many variables, including the expansion of Medicaid in Pennsylvania in 2015, which added 900,000 more people to coverage. In 2022, the state extended Medicaid postpartum coverage from 60 days after the end of a pregnancy to one year. Click here to learn more.

The U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services (CMS) Notice of Benefit and Payment Parameters (NBPP) for PY2025 proposed rule was issued in Nov 2023 for comment on proposed standards for issuers and marketplaces as well as requirements for agents, brokers, web-brokers, enrollment entities and assisters to help marketplace consumers. Pennie provided comments prior to the deadline on Jan 8. The proposed rules once finalized will take effect in 2025. The NBPP:

• Proposes new federal standards for certain marketplace operational procedures and would require state-based marketplaces (SBMs) to implement new network adequacy requirements
• Provides additional flexibilities for state implementation of Essential Health Benefit (EHB) standards
• Would remove certain administrative barriers that prevent individuals from gaining and maintaining coverage, while extending enrollment opportunities during the plan year
• Provides guidance for states on the federally-facilitated marketplace (FFM) and state-based marketplaces on the federal platform (SBM-FP) regarding the implementation of standardized and non-standardized plans and asks whether it should require state-based marketplaces (SBM) to implement standardized plans
• Would require state agencies, including marketplaces, to pay to use an optional federal income verification data check that Pennie currently uses

Pennie responded with support for:

• CMS providing State-based marketplaces (SBMs) the necessary flexibility to determine how to implement standardized options as states are in the best position to determine what will best meet the needs of their individual markets.
• The proposal to allow the inclusion of routine adult dental services as an Essential Health Benefit
• The proposal clarifying that issuers have the flexibility to extend monthly premium payment deadlines when they experience billing or enrollment problems due to high volume or technical errors or are directed to do so by applicable state or federal authorities.
• The proposal to allow all exchanges to accept an applicant’s attestation of incarceration status without having to electronically verify that a consumer is not incarcerated
• The proposal to make the Special Enrollment Period (SEP) for individuals with household income at, or below, 150 percent of the federal poverty level (FPL) permanent
• Keeping federal regulations agnostic as to which state entity establishes and enforces network adequacy standards, provided such standards meet or exceed any federal minimum standard

Pennie opposes CMS’s proposal to require SBMs that utilize the optional Verify Current Income (VCI), or Equifax, check within the Federal Data Services Hub (FDSH) to now pay for the service. Pennie currently utilizes this service as a secondary income verification source when the Internal Revenue Service (IRS) returns applicant income data that is inconsistent with the income attested on a Pennie application.