- 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
Pennsylvania Senate Advances Telemedicine Bill
During the week of October 28, 2019, the Pennsylvania Senate quickly fast-tracked a telemedicine bill that nearly made it to Governor Wolf’s desk last December. Senate Bill 857 expands the use of telemedicine for providers, including Community Health Centers , to provide care and receive reimbursement from both managed care organizations (MCOs) and commercial insurance. One new caveat to the bill is a requirement for any affected licensure boards overseeing specialties to promulgate regulations within 24 months of passage. As of October 30, the legislation is before the House for consideration.
Pennsylvania Partnerships for Children’s Annual State of Children’s Health Care Report Released
The opportunity to prosper begins with preventive health care when children are young. A healthy start includes immunizations, screenings, regular dental care, well-child visits and access to nutritious food. However, 124,000 Pennsylvania children do not have health insurance, and children under six are the most likely to be without coverage according to our newest report, “State of Children’s Health Care in Pennsylvania: Powering Up Healthy Kids.”
While Pennsylvania’s uninsured rate falls below the national average, it remains stagnant at 4.4 percent, with Pennsylvania ranking in the middle of the pack at 24th for the percentage of uninsured children.
According to a new report released by the Georgetown University Center for Children and Families, the number of uninsured children increased nationally by more than 400,000 between 2016 and 2018, reversing a long-standing positive trend.
No child should be without health care insurance and our report sets a clear agenda to strengthen both access and coverage benefits in health care for the Commonwealth’s children.
A New Website for Substance Use Disorder Care
(AP/PBS Newshour, 10/30/19)
The Trump administration has launched a website intended to help people connect with treatment options for substance use disorders. The website, FindTreatment.gov, includes customizable tools that allow users to search for providers based on the type of treatment they want—including detox, inpatient, or telemedicine—and by payment method and insurance type.
Research: Policy Change and Implementation of a Needle Exchange Program Averts More than 10,000 Potential Diagnoses of HIV
Syringe exchange programs (SEP) reduce HIV incidence associated with injection drug use (IDU), but legislation often prohibits implementation. We examined the policy change impact allowing for SEP implementation on HIV diagnoses among people who inject drugs in 2 US cities.
Using surveillance data from Philadelphia (1984–2015) and Baltimore (1985–2013) for IDU-associated HIV diagnoses, we used autoregressive integrated moving averages modeling to conduct 2 tests to measure policy change impact. We forecast the number of expected HIV diagnoses per city had policy not changed in the 10 years after implementation and compared it with the number of observed diagnoses postpolicy change, obtaining an estimate for averted HIV diagnoses. We then used interrupted time series analysis to assess the immediate step and trajectory impact of policy change implementation on IDU-attributable HIV diagnoses.
The Philadelphia (1993–2002) model predicted 15,248 new IDU-associated HIV diagnoses versus 4656 observed diagnoses, yielding 10,592 averted HIV diagnoses over 10 years. The Baltimore model (1995–2004) predicted 7263 IDU-associated HIV diagnoses versus 5372 observed diagnoses, yielding 1891 averted HIV diagnoses over 10 years. Considering program expenses and conservative estimates of public sector savings, the 1-year return on investment in SEPs remains high: $243.4 M (Philadelphia) and $62.4 M (Baltimore).
The authors conclude that pPolicy change is an effective structural intervention with substantial public health and societal benefits, including reduced HIV diagnoses among people who inject drugs and significant cost savings to publicly funded HIV care.
Access the full report here.
Pike Dental Center Awarded $300,000 Grant for Expansion
Honesdale, PA (October 30, 2019) — Treatment for nearly 2,000 additional patients at the Pike Dental Center will be made possible through a $300,000 grant from the Oral Health Infrastructure Grant Program of the Health Resources and Services Administration (HRSA).
Officials of Wayne Memorial Community Health Centers (WMCHC) were notified of the grant award earlier this month. The monies will be used to create a 748 square foot expansion within the existing dental center located in Lords Valley, PA. The result, an increase from five to nine operatories at the facility, has the potential of generating between 8,500 – 9,000 additional dental visits per year.
Pike Dental Center was constructed to meet the growing demand for accessible dental care for the greater Pike County area. The state-of-the-art facility first opened its doors in January of 2014 with a total of five operatories. The Lords Valley office, currently staffed by Megan Martino, DMD and John Ridd, DMD, is an extension of the Together For Health Dental Center in Honesdale.
“Even with the development of the Pike office having taken place no more than five years ago, it remains a challenge to provide care as timely as we’d like,” stated Frederick Jackson, executive director, WMCHC. “Wait times exceed four months for some services.”
According to WMCHC’s Dental Manager Nichole Yannone, it became evident as early on as 2015 that the current Pike facility wasn’t large enough to meet the need of the service area. Yannone says the dentists, hygienists and support staff at Pike Dental look forward to the “increased access to care, appointment availability and additional space in which to work” that will be realized when the expansion comes to fruition.
Jackson explained that WMCHC is still “in the design phase of the project” at this time. However, it is hoped that construction will begin in early 2020 with completion by the summer.
WMCHC is a federally qualified health center clinically affiliated with Wayne Memorial Health System, Inc. In addition to dental services, WMCHC offers primary care, women’s health, pediatric services, pulmonology, general surgery and behavioral health services at satellite offices located in Wayne, Pike, Lackawanna and Susquehanna Counties. For more information on all services, call 570-253-8390 or visit wmchc.net.
Rural America is Not an Economic Liability
From the Rural Yonder, October 29, 2019
Rural America as a whole has struggled with population loss and sluggish job growth during the past decade, but some areas have managed to buck these trends and may serve as bright spots for those focused on economic development outside of cities.
New research from the Center for American Progress, a liberal think-tank, attempts to highlight some of the assets rural areas might use to their advantage and also points out that the fortunes of rural communities differ widely by region and based on other factors.
“What we’re trying to drive home is that rural America is not an economic liability,” said Zoe Willingham, who co-authored the center’s policy brief.
Read the full article here.
Harvested Cropland and Vegetables in the Pennsylvania
This brief from the Pennsylvania State Data Center celebrates the fall season with a look at agriculture across Pennsylvania according to the 2017 Census of Agriculture. Some of the data highlights include:
- Pennsylvania had over 4 million acres of harvested cropland in 2017.
- Nearly half (48.5%) of Lancaster County’s land area is devoted to harvested cropland.
- Over 48,000 acres of vegetables were harvested in Pennsylvania in 2017.
Which vegetable was the most harvested in each county? Click here to read more about trends in harvested cropland and vegetables harvested across the state.
Advocates Urge Education And Training On Human Trafficking “In Your Backyard” At Summit
In 2018, 127 cases of human trafficking were reported in Pennsylvania, according to the National Human Trafficking Hotline. At the 2019 Rural Human Trafficking Summit hosted by the Pennsylvania Office of Rural Health at Penn State Tuesday, advocates said that to target and stop trafficking, the public needs to first recognize the situation.
The National Human Trafficking Hotline reported nearly 8,000 cases of sex trafficking in 2018, and about 1,200 case of labor trafficking. The organization says the statistic doesn’t necessarily mean sex trafficking is more prevalent than labor trafficking, only that people are more aware of the former.
Jane Guerino, a survivor of sex trafficking, said most people don’t believe trafficking is happening in Pennsylvania or outside of urban areas. She was abducted at the age of 30 in Allentown, Pennsylvania.
“It is here. It’s in your backyard. It is with your children, and you don’t know it and you don’t realize it until they’re abducted or they’re taken into trafficking,” she said.
Guerino is the president of the Glory House in Allentown, a transitional home for victims of human trafficking and domestic violence. She warned that dating websites and the internet as a whole are often used by traffickers to lure potential victims into trafficking. Young girls and women should be especially vigilant and cautious, she said, as they’re the most likely targets.
Guerino, who was one of the speakers at the summit, said medical professionals and law enforcement agencies need more training on recognizing signs of human trafficking in victims. They may come in contact with emergency rooms or police officers while showing bruising or displaying anxiety.
Shea Rhodes, who directs the Institute to Address Commercial Sexual Exploitation at Villanova University, talked about prosecuting the traffickers and buyers in the billion-dollar industry instead of the victims.
“Pennsylvania is really starting to — and our legislature is recognizing that, unless we target the sex buyers to drive down that demand for commercial sex, the traffickers are going to continue to capitalize and be able to make money,” Rhodes said.
She helped push the state to enact a comprehensive legislation that defines both sex trafficking and labor trafficking in 2014, “the most meaningful change” from the legal perspective.
“Every year since that law has gone into effect, we’ve been working with the legislature to continue to move that ball forward,” Rhodes said.
One of the additions is a Safe Harbor Law, which the state enacted in 2018, ensuring child victims of human trafficking don’t get prosecuted for prostitution or other crimes.
“We really need to change the public perception as to what prostitution is,” Rhodes said. “And all of those terrible synonyms and the stigma that goes along with that particular crime. It’s actually, in our opinion, exploitive, and we don’t think anyone, who is being either sold for sex, or selling sex because they have no other way to survive, should be criminalized.” So far, the 2014 legislation has led to 46 convictions in the state.
If you or someone you know is a victim of human trafficking, you can get help by calling the National Human Trafficking Hotline, 1-888-373-7888 or text 233733.
CMS Delays New Value-based Payment Models
The Centers for Medicare and Medicaid Services (CMS) announced it is delaying the start of several new voluntary value-based payment models, including the Primary Care First and Kidney Care First models, until at least 2021. However, CMS continued to encourage Medicare providers to apply to participate in the models. (Source: Modern Healthcare‘s “Transformation Hub,” 10/24)
Judge Orders Fed to Pay Insurers $1.6B
A federal judge in a final judgement issued last week ordered the federal government to reimburse nearly 100 health insurers about $1.6 billion in unpaid cost-sharing reduction payments called for under the Affordable Care Act. The ruling is the latest of several decisions stating that the federal government is required to make the payments, which total billions of dollars, but the Department of Justice has appealed those rulings. (Source: Modern Healthcare, 10/24)