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Multilingual Resources and Materials for Medicare Providers

The HHS Office of Minority Health has partnered with the Centers for Medicare & Medicaid Services (CMS) and other HHS agencies to identify and compile multilingual resources and materials for Medicare providers to assist them in providing culturally and linguistically appropriate services.

Translated resources include materials and information regarding specific diseases and conditions, health insurance, women’s health topics, substance use, emergency preparedness and response, and more.

Translated resources include materials and information regarding specific diseases and conditions, health insurance, women’s health topics, substance use, emergency preparedness and response, and more.

Download the file here to access translated resources and materials for Medicare providers.

Anniversary of the Affordable Care Act

On March 22, 2021, U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra released the following statement on the eve of 11th anniversary of the Affordable Care Act:

“In the eleven years since it became law, the Affordable Care Act has saved lives, brought down health care costs, and expanded Medicaid to our most vulnerable neighbors. The lifesaving law has been a game changer, protecting roughly 133 million people with pre-existing conditions and extending quality, affordable health care to millions more.

“While health care is more in reach today, we have more work to do. The COVID-19 pandemic has thrust families into crisis. Over the last year, too many people have had to mourn lost love ones or struggle to pay their bills. President Biden promised to bring down health care costs and that is exactly what we at the Department of Health and Human Services will do, beginning with implementation of the American Rescue Plan.

“Beginning on April 1, millions of Americans will be eligible for even more affordable options on HealthCare.gov. Because of the American Rescue Plan, four out of five enrollees will be able to qualify for coverage for as little as $10 per month.

“As HHS Secretary, I’m committed to building on this monumental progress to bring every American the peace of mind that comes with knowing you can take care of your family without going into debt.”

2021 Special Enrollment Period Access Extended to August 15, 2021 on HealthCare.gov for Marketplace Coverage

On March 23, 2021, President Biden announced that the Centers for Medicare & Medicaid Services (CMS) is extending access to the Special Enrollment Period (SEP) until August 15 – giving consumers additional time to take advantage of new savings through the American Rescue Plan. This action provides new and current enrollees an additional three months to enroll or re-evaluate their coverage needs with increased tax credits available to reduce premiums.

“Every American deserves access to quality, affordable health care – especially as we fight back against the COVID-19 pandemic,” said HHS Secretary Xavier Becerra. “Through this Special Enrollment Period, the Biden Administration is giving the American people the chance they need to find an affordable health care plan that works for them. The American Rescue Plan will bring costs down for millions of Americans, and I encourage consumers to visit HealthCare.gov and sign up for a plan before August 15.”

To read the HHS press release, visit: HHS Press Release

To view the extended opportunity SEP fact sheet, visit: Extended Opportunity 2021 SEP Fact Sheet

See the updated technical guidance on the SEP at: SEP Technical Guidance

For FAQs on the 2021 SEP and the American Rescue Plan visit: SEP and ARP FAQs

Social Media

Please help us to amplify this announcement on your social channels:

Today, @POTUS announced that @CMSgov is extending access to the Marketplace Special Enrollment Period until August 15.  Access the tweet at:  https://twitter.com/HHSGov/status/1374479825897844737?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Etweet

Pennsylvania Insurance Department Issues Guidance to Insurers for Consumer Protection, Calls for Clarity in Telehealth Policies

Pennsylvania Insurance Commissioner Jessica Altman announced that the Department of Insurance has issued guidance on health insurance-related services to protect consumers, and to call for clarity in insurers’ telehealth policies during the ongoing COVID-19 pandemic. A notice, which was included in the March 6 Pennsylvania Bulletin, outlines expectations regarding coverage by insurers of testing and vaccine administration to Pennsylvanians, and urges continued telehealth flexibility to make both COVID-related services and non-COVID-related services available to consumers.

“As we continue our fight against COVID-19, it is vital to make sure all Pennsylvanians have access to the resources needed to combat this public health crisis, and that includes testing and vaccination options,” Commissioner Altman said. “Health insurers play a critical role in access and affordability of these services and should ensure that most consumers can access these services at no cost to the consumers. The carriers have been an important partner in the commonwealth’s response to COVID, and we look forward to that continued partnership as we forge through the next stages of our pandemic response.”

The notice highlights the expectation that insurers will continue to cover COVID testing and vaccination without cost-sharing as required under The Families First Coronavirus Response Act (FFCRA) and Coronavirus Aid, Relief, and Economic Security Act (CARES Act). The notice also calls for health insurers to assist consumers in accessing in-network or publicly funded health services to avoid balance billing or surprise balance bills. Mechanisms should already be in place to prevent surprise balance billing for COVID-related services, but the department urges insurers to take steps now to make necessary changes to billing services in anticipation of the No Surprises Act, taking effect in 2022.

The notice also calls for clarity and consistency in insurers’ telehealth policies across the commonwealth while the COVID-19 health emergency is ongoing. A previous notice encouraged health insurers to allow for flexibility in telehealth services, and many insurers implemented flexibilities in their policies and coverage of telehealth services, some permanently. However, different approaches and timelines has caused confusion for both providers and consumers.

“We appreciate the insurers that have made an effort to expand access to telehealth services during the pandemic, allowing for continued routine and urgent health care for the duration of the public health emergency,” said Altman. “The department is now encouraging insurers to implement consistency in these policy flexibilities, most particularly by aligning policies with emergency declaration dates and offering network flexibility for providers that offer both telehealth and in-person services.”

The department notice encourages telehealth policy flexibilities to be extended through the end of the federal or Pennsylvania public health emergency and suggests a 60-day wind-down period for flexibilities to provide for an orderly transition for both providers and patients.

“As we enter the second year of the COVID-19 pandemic and the situation continues to evolve, we ask insurers for their continued readiness to make any necessary changes in policy to address the crisis head on,” added Altman. “We appreciate the commonwealth-wide response we have seen thus far in providing coverage and care for all Pennsylvanians.”

The department has submitted various notices to the Pennsylvania Bulletin to help ease the hardships that are being felt by Pennsylvanians during this crisis and ensure minimum disruption to the department and commonwealth-regulated operations.

If a consumer receives an unexpected bill related to COVID-19, or other healthcare services, they are encouraged to contact the department at 1-877-881-6388.

What Have We Learned About Health Systems – A Synthesis

As part of the RAND Center of Excellence on Health System Performance, researchers from RAND Corporation, Penn State, UCLA, Stanford, and Harvard have taken a “deep dive” into 24 health systems and their affiliated physician organizations in four regions of the United States. For these studies, a health system is defined as having at least one hospital and at least one physician organization affiliated through shared ownership or a contractual relationship.

In brief:

  • If you’ve seen one health system, you’ve seen one health system
  • Integration is a multi-layered concept—structural, functional, and clinical—each of which may affect health system performance
  • A single interoperable EHR—accessible to allaffiliated physicians—is considered the gold standard—but implementation is by no means universal
  • Health systems are taking a highly individualized approach to care delivery redesign, with an emphasis on standardizing and increasing the efficiency of existing practices over disruptive innovation
  • The pace at which value-based payment arrangements are being implemented by the government and commercial payers may be too slow to support transformation of care delivery
  • Structural integration does not necessarily signal clinical integration

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Pennsylvania Launches Emergency Rental Assistance Program

Pennsylvania Governor Tom Wolf announced the launch of a program that will deliver rapid relief to millions of Pennsylvanians at risk of eviction or loss of utility service. With federal funds allocated through the Consolidated Appropriations Act of 2021, the Wolf Administration built the Emergency Rental Assistance Program (ERAP) in partnership with the General Assembly through Act 1 of 2021 to distribute about $569 million to Pennsylvania households through partnerships with local leaders. An additional $278 million in rental assistance was directly allocated to Pennsylvania’s largest counties by the federal government.

“With thousands of COVID-19 vaccines administered to Pennsylvanians every day, we are starting to see the light at the end of this year-long tunnel. But we must remain focused on the fact that so many of our neighbors are still struggling to cope with the pandemic’s economic fallout,” Governor Wolf said. “Millions of Pennsylvania households are less financially secure today than they were a year ago because a pandemic stole jobs and income from Pennsylvania workers. The ERAP is designed to provide housing security and utility assistance for these families and individuals so that they can focus on caring for their loved ones, getting back to work and healing from this traumatic experience.”

Pennsylvanians can submit applications for the Emergency Rental Assistance Program online at www.compass.state.pa.us. Forty-seven counties have opted to collect applications from county residents through the COMPASS website provided by the Department of Human Services (DHS). DHS will route applications submitted through COMPASS directly to counties for processing.

The online application is available in English and Spanish. Applicants can also download and print an application or obtain an application from their county ERAP office.  DHS has also translated the paper application into RussianVietnameseArabicChinese and Cambodian and made those available to all participating counties.

Twenty counties have opted to accept applications from county residents through their own application process. However, residents of all counties can visit COMPASS for information on how to apply for ERAP, including residents of counties that have developed their own process. If a person tries to apply through COMPASS but indicates that they reside in one of the 20 counties with its own application, they will be provided with information about how to apply, including a link to the county application if available.

“The Department of Human Services designed this program to quickly and efficiently get help to people who need it. We stand ready to work with our partners in every Pennsylvania county to make this program a success,” DHS Secretary Teresa Miller said. “I encourage all Pennsylvania families and individuals struggling with rent and utility bills to apply for assistance through ERAP.”

Households may be eligible for up to 12 months of assistance to cover past-due or future rental and/or utility payments. The amount of a household’s monthly rent or utility bills does not preclude eligibility, but the amount of ERAP assistance provided to a household is determined by program administrators at the county level.

Assistance can be provided to a tenant for future rental payments, and for unpaid rental or utility arrears that were accrued on or after March 13, 2020 on a residential rental property. Counties may choose to provide additional assistance to eligible households if funds remain available.

Residential tenants can apply for themselves, or a landlord/utility provider can apply on behalf of a current tenant. Additionally, landlords do not have to agree to participate in the program for tenants to receive assistance.

To qualify for assistance, a household must be responsible to pay rent on a residential property and meet each of the following criteria:

  • One or more people within the household has qualified for unemployment benefits, had a decrease in income, had increased household costs, or experienced other financial hardship due directly or indirectly to the COVID-19 pandemic; AND
  • One or more individuals in the household can show a risk of experiencing homelessness or housing instability; AND
  • The household has an income at or below 80 percent of area median income, which varies by county. Income limits by county are available on the DHS website. Resources (like bank accounts and cars) are not relevant to ERAP eligibility.

Applicants will need to provide the following information: head of household’s personal information; income information for all household members 18 and older; rental lease and amount owed; landlord’s name and contact information. If applying for utility assistance, applicants must provide utility expenses and utility provider information.

Applicants should be prepared to provide documents that substantiate information provided, such as pay stubs, tax filings, unemployment letters, and rental/utility arrears. However, if applicants do not have documents, county ERAP offices will work with applicants to obtain documents or written attestations.

The program will end when all funds have been expended, which DHS expects to happen by September 2021. Per Act 1 of 2021, all funds must be spent by December 31, 2021.

More information about ERAP can be found at www.dhs.pa.gov.

New Report: Prescription Drug Monitoring Programs Are a Tool, Not a Single Solution to Reduce Opioid-related Deaths 

Despite the success of Pennsylvania’s drug monitoring program against overprescribing, overall overdose deaths increased.

Yunfeng Shi, PhD, Assistant Professor of Health Policy and Administration at Penn State, recently was interviewed by PublicSource about Pennsylvania’s Prescription Drug Monitoring Program (PDMP). Launched in 2016, the program tracks prescriptions of controlled substances to prevent overprescribing. All providers authorized to prescribe controlled substances must register with the program and pharmacies and other dispensers must enter data by the end of the next business day to ensure the PDMP information is up-to-date. Failure to meet the provisions of the PDMP law could result in sanctions. Shi thinks the mandates are essential: “Studies have observed the reduction in opioid prescriptions when you have a PDMP that holds physicians legally accountable.”

Despite the success of Pennsylvania’s PDMP in curtailing overprescribing, effectively decreasing chances for patients to become addicted to opioids and other substances, its success against the opioid epidemic is limited as overall overdose deaths increased in 2020 (note that the convergence of the COVID-19 pandemic and opioid epidemic proved uniquely challenging). According to Shi, “PDMPs are a program to reduce unnecessary opioid prescriptions” but “alone can’t win the fight to reduce opioid-related deaths.” Jeff Hanley, executive director of the Commonwealth Prevention Alliance, echoed Shi, viewing prevention programs as a “long-term solution that would be more effective in the future once we had the kinks worked out.”

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Pennsylvania Launches Portal to Ensure High-Risk Populations Have Access to Opioid Reversal Medication

Pennsylvania Governor’s Wolf Administration’s Opioid Command Center announced the availability of the Statewide Naloxone Allocation Request Portal. The portal allows eligible organizations serving high-risk populations the ability to request additional naloxone nasal spray.

“We are committed to ensuring that naloxone is widely available to help those with the disease of addiction,” Acting Secretary of Health Alison Beam said. “Naloxone has one role, and that is to save someone who is suffering from an overdose. It is essential that every Pennsylvanian consider obtaining naloxone to help save a life.”

This portal will supplement the Central Coordinating Entities’ (CCEs) efforts through the Naloxone for First Responders Program (NFRP) with a dedicated supply of naloxone focused on supporting distribution efforts to reach high-risk and high-need populations.

Eligible organizations must utilize naloxone provided through this portal to support one or more of the following priority populations:

  • Individuals using Syringe Service Programs (SSPs) and harm reduction services;
  • Individuals leaving state prisons and county jails;
  • Individuals engaged in and/or leaving treatment or detox and those who are in recovery;
  • Individuals who have experienced a nonfatal overdose; and/or
  • Other high-risk populations identified by the organization (i.e., pregnant/post-partum women with a history of opioid use disorder, individuals experiencing homelessness, etc.).

“Naloxone has been a key component of battling the opioid epidemic in Pennsylvania,” said Department of Drug and Alcohol Programs Secretary Jen Smith. “The Wolf Administration has worked hard to ensure that all Pennsylvanians have access to naloxone. This portal will help ensure that we are able to fulfill the needs of the commonwealth’s more high-risk overdose populations, and ultimately save lives.”

Launched in 2017, the goal of the NFRP is to increase the availability of lifesaving medication for individuals at greatest risk of opioid overdose as well as the systems most likely to interact with these individuals. NFRP provides no-cost intranasal naloxone to priority first responder groups through a network of 48 CCEs. Since inception, CCEs have distributed more than 80,000 kits of NARCAN to first responder groups, resulting in more than 17,094 reported overdose reversals to date.

“PCCD remains committed to the distribution of naloxone throughout the state to prevent overdose deaths and save lives,” Pennsylvania Commission on Crime and Delinquency Executive Director Michael Pennington said.  “Our agency will continue to work with our partners at the state and local levels to increase availability of this life-saving medication for individuals and communities with the greatest need.”

Additional naloxone efforts include the Pennsylvania Department of Health’s standing orders to make naloxone more accessible for the public, first responders, and last year, a standing order for community organizations to distribute naloxone through mail order. Additionally, the Wolf Administration has sponsored two public giveaway events as part of Stop Overdose in Pennsylvania: Get Help Now week, where nearly 10,000 kits of naloxone were distributed.

The Opioid Command Center, established in January 2018 when Gov. Wolf signed the first opioid disaster declaration, meets every week to discuss the opioid crisis. The command center is staffed by personnel from 17 state agencies and the Office of the Attorney General, spearheaded by the departments of Health and Drug and Alcohol Programs. Last year, the command center released a strategic plan highlighting accomplishments to date and providing a roadmap for the continued work to help those with substance use disorder.

Efforts over the past several years, working with state agencies, local, regional, and federal officials, have resulted in significant action to address the opioid crisis.

  • Physician General  signed an updated naloxone standing order permitting community-based organizations to provide naloxone by mail.
  • In September, DDAP announced the launch of Life Unites Us, an anti-stigma campaign, utilizing social media platforms to spread real-life stories of individuals and their family members battling substance use disorder, live and recorded webinars detailing tools and information necessary to effectively reduce stigma to more than 350 community-based organizations focused on SUD prevention, treatment, and recovery throughout Pennsylvania, and a web-based interactive data dashboard detailing the progress of the campaign.
  • The Wolf Administration called on all Pennsylvanians to carry naloxone.
  • The Prescription Drug Monitoring Program has reduced opioid prescriptions by 36.6 percent and has virtually eliminated doctor shopping.
  • The number of people receiving high dosages of opioids (defined as greater than 90 morphine milligram equivalents per day) has dropped 58.6 percent since the PDMP launched in August 2016.
  • The Opioid Data Dashboard and Data Dashboard 2.0 has provided public-facing data regarding prevention, rescue and treatment.
  • Pennsylvania Coordinated Medication Assisted Treatment (PacMAT) programs are serving as part of a hub-and-spoke model to provide evidence-based treatment to people where they live. 8 PacMAT programs have served patients through this initiative.
  • More than 45 Centers of Excellence, administered by the Department of Human Services, provide coordinated, evidence-based treatment to people with an opioid use disorder covered by Medicaid. The COEs have treated more than 32,500 people since first launching in 2016.
  • The waiver of birth certificate fees for those with opioid use disorder has helped more than 6,090 people, enabling easier entry into recovery programs.
  • A standing order signed by former Secretary of Health Dr. Rachel Levine in 2018 allowed EMS to leave behind more than 2,400 doses of naloxone.
  • Education has been provided to more than 9,500 prescribers through either online or face-to-face education.
  • More than 880 drug take-back boxes help Pennsylvanians properly dispose of unwanted drugs, including 178,540 pounds of unwanted drugs in 2019. 2020 data is not yet available because of COVID.
  • The Get Help Now Hotline received more than 49,000 calls, with more than half of all callers connected directly to a treatment provider.
  • The state prison system has expanded their Medication Assisted Treatment (MAT) program, which is viewed as a model program for other states.
  • A body scanner pilot project was successful in reducing overdoses and violent crime in a number of facilities. Body scanners are in place in more than 30 locations and are currently being expanded to additional facilities.
  • Several agencies have worked together to collaborate on the seizure and destruction of illicit opioids across Pennsylvania.
  • Education and training on opioids have been provided to schools. Future plans are in place to make opioid education a standard component of school-based training.
  • The coordination with seven major commercial providers has expand access to naloxone and mental health care, while also working to make it more affordable.
  • Naloxone has been made available to first responders through the Pennsylvania Commission on Crime and Delinquency since November 2017, with more than 80,000 kits made available and more than 17,094 overdose reversals reported through the program. More than 6,600 of those saves occurred in 2019.
  • EMS have administered more than 51,760 doses of naloxone and more than 10,000 doses were made available to members of the public during the state’s naloxone distribution in 2019.

More information on the opioid crisis can be found on the Department of Health’s website at health.pa.gov or follow us on Facebook and Twitter.

Pennsylvania Agriculture Department to Business Travelers: Don’t Take it With You — Get a Spotted Lanternfly Permit

Pennsylvania Agriculture Secretary Russell Redding encouraged business travelers to join more than 1.2 million people at 26,000-plus companies across the U.S. and Canada who have learned how to recognize Spotted Lanternflies and keep from giving the destructive pest a ride to a new home. A permit is required for business travel, regardless of type of cargo, since hitchhiking is the primary way the invasive insect spreads to new areas.

“Spotted Lanternflies don’t check to see what you’re transporting,” said Redding. “They hop on anything in their path and hitch a ride to a new home. It only takes one egg mass or one pregnant female insect to start an infestation. Ask anyone who lives in Southeast Pennsylvania — you don’t want this pest in your neighborhood, you certainly don’t want it dining on the crops that feed our economy, and you don’t want to be the business that brought it home.”

Last week, the department announced the addition of eight counties to Pennsylvania’s Spotted Lanternfly quarantine zone ahead of the 2021 spring hatch. In addition to special requirements for companies that produce or ship agricultural goods, the quarantine requires companies whose employees travel for business in and out of Cambria, Cameron, Franklin, Lackawanna, Montour, Pike, Wayne, Westmoreland counties as well as the 26 previously quarantined counties to have Spotted Lanternfly permits.

Obtaining a permit involves taking a brief online course to learn how to recognize the insect at every phase of its lifecycle and how to inspect vehicles and contents to prevent transporting the insect. Each company determines which of their employees should have a permit. A company with a permit can then tailor training specifically for inspecting the types of vehicles they use and the cargo they transport.

Businesses outside the agriculture industry whose employees have lanternfly permits include Pennsylvania state agencies and the legislature. A map and list of companies that have obtained permits, along with the number of business travelers represented, is on the department’s website, as well as information to help businesses determine who is required to have a permit.

“Human travelers pose the biggest risk when it comes to spreading Spotted Lanternflies,” Redding said. “To protect our quality of life, our businesses like stadiums and restaurants that depend on their customers enjoying the outdoors, and the tens of thousands of jobs that depend on agriculture, we must all do our parts. If you run a business in the quarantine zone or travel to and from the quarantine zone for work, get a permit. Learn how you can keep from spreading this destructive pest.”

Counties added to the quarantine in 2020 and 2021 have isolated insect populations, as opposed to widespread infestations. In many instances, it is clear the insects got there by hitchhiking, since they do not travel great distances on their own. Transportation corridors, such as major highways, railways, trucking centers and tourist destinations, have been a top priority in the strategy the department and the USDA have followed in efforts to control the spread of the insect.

Quick, aggressive treatment of newly identified Spotted Lanternfly populations in Pennsylvania has been funded through the Rapid Response Disaster Readiness line of Governor Tom Wolf’s Pennsylvania Farm Bill for the past two years. The 2021-22 PA Farm Bill proposes another $3 million to combat Spotted Lanternfly.

Since 2015, the department has received more than $34 million to combat Spotted Lanternfly in Pennsylvania – $20 million in federal funds and another $14 million in state investment. The department also awarded more than $260,000 in January for four priority research projects. These investments have funded the work of researchers learning how to control the insect in an environment where it doesn’t belong, as well as the work of those putting the research into practice and preventing its spread.

For more information on Spotted Lanternfly, visit agriculture.pa.gov/spottedlanternfly. For more about Governor Wolf’s PA Farm Bill investments in a sustainable agriculture industry visit agriculture.pa.gov/pafarmbill.

Pennsylvania Amends Universal Face Coverings Order to Align with CDC Guidance

Pennsylvania Acting Secretary of Health Alison Beam today amended the existing Universal Face Coverings order, issued on November 17, 2020, to align with the Centers for Disease Control and Prevention’s (CDC) Recommendations for Fully Vaccinated People. The amended order went into effect at 12:01 a.m. on March 17, 2021 and will remain in effect until further notice.

“The vaccines that are currently available across the state and country are highly effective at protecting vaccinated people against severe and symptomatic COVID-19,” Acting Secretary Beam said. “Research has shown that fully vaccinated people are less likely to have asymptomatic infection and potentially less likely to spread the virus that causes COVID-19 to others. However, there is still more to learn about how long protection lasts and how much vaccines protect against new variants of the virus, so some prevention measures will continue to be in place for all people, regardless of their vaccination status.”

According to the CDC, there are several activities that fully vaccinated people can resume now, as low risk to themselves, while being mindful of the potential risk of transmitting the virus to others. Those activities include:

  • Visiting with other fully vaccinated people indoors without wearing masks or physical distancing;
  • Visiting with unvaccinated people from a single household who are at low risk for severe COVID-19 disease indoors without wearing masks or physical distancing; and
  • Refraining from quarantine and testing following a known exposure, if asymptomatic.

However, it is important that fully vaccinated people continue to take precautions in public like wearing a mask and practicing physical distancing; avoid medium- and large-sized in-person gatherings; get tested if they experience COVID-19 symptoms; follow guidance issued by employers; and follow travel requirements and recommendations.

Individuals who are fully vaccinated should also continue to wear a mask, practice physical distancing and follow other prevention measures when visiting unvaccinated people who are at increased risk for severe COVID-19 disease or who have an unvaccinated household member who is at increased risk for severe COVID-19 disease and when visiting unvaccinated people from multiple households.

People are considered fully vaccinated for COVID-19 more than two weeks after they have received the second dose in a two-dose series or more than two weeks after they have received a single-dose vaccine. It is important to remember that the current mitigation Orders are still in effect and that physical distancing and capacity requirements for gatherings must still be followed.