- CMS: Medicare Program; Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction (WISeR) Model
- Public Inspection: CMS: Medicare Program: Implementation of Prior Authorization for Select Services for the Wasteful and Inappropriate Services Reduction Model
- CMS: Secretarial Comments on the CBE's (Battelle Memorial Institute) 2024 Activities: Report to Congress and the Secretary of the Department of Health and Human Services
- HHS: Patient Protection and Affordable Care Act: Marketplace Integrity and Affordability
- HRSA Announces Action to Lower Out-of-Pocket Costs for Life-Saving Medications at Health Centers Nationwide
- Public Inspection: HHS: Patient Protection and Affordable Care Act: Marketplace Integrity and Affordability
- Increased Risk of Cyber Threats Against Healthcare and Public Health Sector
- Eight Hospitals Selected for First Cohort of Rural Hospital Stabilization Program
- Announcing the 2030 Census Disclosure Avoidance Research Program
- CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction
- CMS: Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and Policy Changes and Fiscal Year 2026 Rates; Requirements for Quality Programs; and Other Policy Changes; Correction
- CMS: Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Correction
- CMS: Medicare and Medicaid Programs; Contract Year 2026 Policy and Technical Changes to the Medicare Advantage Program, Medicare Prescription Drug Benefit Program, Medicare Cost Plan Program, and Programs of All-Inclusive Care for the Elderly; Correction
- CMS: Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities; Updates to the Quality Reporting Program for Federal Fiscal Year 2026
- CMS: Medicare Program; FY 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
Cost for Family of 4 to Live without Help in Philly: $70,000 a Year
A Philadelphia family of four must make more than $70,000 a year just to survive, a new report says – a stunning sum beyond the reach of most residents in a city beset by high poverty and meager chances. According to the newly released study based on 2019 data, two adults with one preschooler and one school-age child have to take in $70,613 to meet their needs without receiving public assistance or help from relatives or friends. Read more.
Medicare Advantage Enrollment Burgeoning
With Open Enrollment ending March 31 for Medicare Advantage plans, Axios reports enrollment rates have increased 9.4 percent over the same time period last year. Medicare Advantage plans are a type of Medicare health plan offered by a private company that contracts with Medicare to provide all your Part A and Part B benefits. Most Medicare Advantage Plans also offer prescription drug coverage. The number of plans available in each county in Pennsylvania varies from 45 plans in Susquehanna County to 61 in Lancaster. To view plan information by county, click here.
Did You Know? Pennsylvania Offers New Mail-In Voting Option
Pennsylvania’s April 28 primary election is still two-and-a-half months away, but it’s not too soon to start thinking about how you will vote in that election. Voters in the commonwealth now have two options for mail ballots:
- Absentee ballot: If you plan to be out of the municipality on election day or if you have a disability or illness, you should request this ballot type, which still requires you to list a reason for your ballot
- Mail-in ballot: If you aren’t an absentee voter, you may apply for a mail-in ballot. You may simply request this ballot without a reason
In order to request either ballot type, you must be registered to vote. Visit Check Your Registration Status to review your registration information.
Capitol Hill Holds Hearings on President Trump’s FY21 Budget Request
After releasing the President’s Budget for FY21, Health and Human Services (HHS) Secretary Alex Azar headed up to Capitol Hill to defend the health care priorities for the Administration. While the majority of the Secretary’s time in front of the Senate and House Appropriations Committees was spent explaining the Administration’s efforts on the Coronavirus, multiple rural health champions were able to share concerns about rural health programs in the budget request. Senator Hyde-Smith (R-MS), Congressman Jodey Arrington (R-TX), Congresswoman Terri Sewell (D-AL) and 2020 NRHA Rural Champion Congressman Brad Wenstrup (R-OH) all were able to press the Secretary on the importance of funding crucial rural health programs.
Addiction Treatment Misses the Mark
A recent Axios article highlights flaws in addiction treatment centers. Reuters recently reported only 15% of patients in residential drug and alcohol treatment programs are receiving medication assisted treatment (MAT). However, research proves that MAT is the most effective form of treatment for those struggling with opioid use disorder (OUD). The article goes into depth about consumers not always having the proper information needed to decide if a treatment center is the best fit for themselves or a family member. Learn more.
Quality Insights Officers Training, Technical Assistance
Quality Insights offers training, technical assistance and outreach to small and mid-sized provider groups and other eligible professionals in Pennsylvania to assist with participation in the Medicaid Promoting Interoperability Program and in meaningfully using EHR systems. Quality Insights engages with Pennsylvania’s certified health information organizations and the Public Health Gateway (PHG) to increase health information exchange in Pennsylvania. For more information, call (877) 346-6180.
Grants Aimed at Connecting Pennsylvania HIOs and Providers
The Pennsylvania Department of Human Services (DHS) has grants available to Pennsylvania health information organizations (HIOs) to help connect hospitals and ambulatory practices to the PA eHealth Partnership Program’s Pennsylvania Patient & Provider Network (P3N). The P3N enables electronic health information exchange across the state through the connection of healthcare providers to an HIO, and the participation of the HIO in the P3N. The anticipated performance period for this grant runs through Sept. 30, 2020 but if you are interested in this program, it is crucial that you reach out to one of the PA certified HIOs as soon as possible. HIO’s must submit bids to DHS by March 24, 2020 for these grants. Information about the PA certified HIOs can be found here.
DEA Seeks Comment on Proposed Mobile Methadone Van Rules
The federal Drug Enforcement Administration (DEA) has released notice of proposed rulemaking on Mobile Methadone Vans for public comment. The DEA proposes to revise the existing regulations for narcotic treatment programs (NTPs) to allow a mobile component associated with the registered program to be considered an equivalent activity. The revisions to these regulations are intended to make maintenance or detoxification treatments more widely available, while ensuring that safeguards are in place to reduce the likelihood of diversion.
Pennsylvania Budget Hearings Continue in Harrisburg
The state Senate and House of Representatives are continuing to hold budget hearings next week. On Wednesday, March 4, the House Appropriations Committee will hold a hearing with the Department of Human Services beginning at 10:00 am. Access the Senate budget hearing schedule and House budget hearing schedule with links to watch them live or listen to recordings of past hearings.
Pennsylvania Takes More Steps to Reduce Prison Population
HARRISBURG — Pennsylvania enacted a new law in February 2020 designed to limit the stays of lower-risk offenders in prison in its latest effort to reduce the state’s prison population and to stop first-time offenders from becoming repeat offenders.
Gov. Tom Wolf, a Democrat, signed the two-bill package shortly after the Republican-controlled Senate approved the bills. The GOP-controlled House did the same Tuesday. Key provisions involve getting shorter-sentence offenders onto parole faster and helping get more lower-risk offenders into programs that are shown to lower recidivism.
In some ways, the legislation was a continuing effort by the state to undo the effect of laws passed in the 1990s that substantially toughened criminal sentences and precipitated a ballooning state prison population. Pennsylvania’s incarceration rate is in the middle of the pack, according to federal data from 2016.
Several elements of the legislation, however, revisit a 2012 law that overhauled the parole system in an effort to shrink the state’s prison population.
Those changes were prompted by a spate of five parolees being arrested over the summer in homicides, most with connections to domestic violence. Victims included two children and Pittsburgh police Officer Calvin Hall.
The bill had broad support from law enforcement groups and criminal justice reform advocates. It’s goal of reducing the state prison population is expected to yield nearly $50 million in savings over five years, money that the state will earmark for use by county-based probation offices.
One key provision allows the automatic parole of certain non-violent offenders after they have served a minimum sentence of two years or less, a change designed to make parole more swift, consistent and efficient.
“I think that’s going to be really significant in reducing our (prison) population,” Secretary of Corrections John Wetzel said. “That presumptive parole is the No. 1 component of the population reduction.”
To help expand the use of the prison system’s intensive inpatient drug treatment program, the legislation streamlines the process through which inmates enter and makes more inmates automatically eligible.
The law also similarly is designed to smooth the path for offenders to enter the prison system’s “boot camp,” a discipline-focused facility that targets behavior modification for young adult offenders who have a higher propensity for violence and misconduct in prison. Research has shown that both the drug treatment program and the boot camp reduce the likelihood of recidivism, state officials say.
It also creates a state advisory committee for county-run probation systems in an effort to improve and standardize how they operate.
Several provisions emerged from the Department of Corrections’ review of cases where parolees were arrested for homicide.
One provision updates a 2012 law to add a trigger for an automatic six-month to one-year jail sentence for a parolee who continually ignores parole conditions, such as going to treatment or counseling.
The 2012 law already has five such triggers, including threatening behavior or possession of a weapon. The sixth provision is designed to address complaints by parole agents that changes over the past decade have stripped them of discretion to pull a potentially dangerous parolee off the street.
The bill also authorizes an annual review of homicides by parolees and provides an intermediate avenue to punish a parole violator, a short-term detention option of up to a week for parole violations that aren’t considered serious enough to warrant a return to prison.