On December 26, CMS approved Pennsylvania’s new 1115 demonstration titled, “Keystones of Health.” The state received authority to provide limited coverage for eligible incarcerated individuals for up to 90 days prior to the individual’s anticipated date of release from state prison or county jail. This approval also provides expenditure authority for certain housing and nutrition-related services to eligible Medicaid beneficiaries based on clinical and social risk criteria. The demonstration is effective through December 31, 2029.

The purpose of MA Bulletin 99-25-01 is to advise providers that the Pennsylvania Department of Human Services (Department) has updated the top 15 non-English languages used by Medical Assistance (MA) beneficiaries and to issue a revised top 15 non-English language tagline document. Additionally, this bulletin reminds providers of their responsibility to provide interpretation and translation services free of charge to all individuals who have Limited English Proficiency (LEP), vision limitations, and/or auditory limitations, and the federal guidelines that must be followed to accomplish this.

House Republicans are floating $2.2 trillion in Medicaid cuts over 10 years, including Medicaid work requirements, per-capita caps, elimination of enhanced federal funding for the Medicaid expansion population, and reversal of the Biden administrations eligibility rule. This news is based on a House Budget Committee chairman’s mark for the years 2025-2034 and a separate menu of offsets obtained by Politico that is based on the GOP’s “Reverse The Curse” proposal. That’s why it is incredibly important to talk with your Member of Congress about the importance of supporting Community Health Centers.

The US House announced its own Make America Healty Again (MAHA) Caucus, a companion to the Senate MAHA Caucus formed after Senators met with Health and Human Services Secretary nominee Robert F. Kennedy, Jr. The House MAHA Caucus is led by Rep. John Joyce, MD, (R-PA) and Rep. Lloyd Smucker (R-PA). As a reminder, the Senate MAHA Caucus explicitly includes “expanding community health centers” under its vision and goals. The House MAHA Caucus has yet to release a document outlining its goals.

House Democrats have reintroduced their medical debt relief bill and the Health Committee has already scheduled a meeting to begin moving the bill. The House Health Committee is set to take up House Bill 79 at a meeting on January 29. Advocates for the proposal say about 1 million Pennsylvanians are struggling with medical debt. Proponents note that those with medical debt, and those afraid of accumulating medical debt, may avoid necessary medical appointments and treatment, which can lead to the need for more expensive care. During his 2024-25 budget address, Gov. Josh Shapiro called for investments to support Pennsylvanians who are being crushed by medical debt, especially those in rural communities. Medical debt impacts Pennsylvanians’ access to quality health care and affects their credit. With only $4 million, the commonwealth can erase nearly $400 million in medical debt for low-income Pennsylvanians by partnering with nonprofits that buy that debt from health care providers for pennies on the dollar. The Department of Health estimates that there is about $1.8 billion in medical debt burden being carried by residents across the state. The House passed a medical debt relief bill in 2023, but it never moved in the Senate.

Rep. Arvin Venkat and Rep. Kristin Marcell have introduced a legislative package, HB 75 and HB 76. These legislative packages would amend the physician licensure acts in Pennsylvania to allow physician assistants to work with either classification of physician, a Doctor of Medicine or Doctor of Osteopathic Medicine, without having to align with the physician’s license type. The current law requires that physician assistants and supervising physicians must be licensed by the same state board.

Continuing the Shapiro Administration’s commitment to get stuff done for Pennsylvanians, the Pennsylvania Insurance Department (PID) today announced that 259 Pennsylvanians successfully appealed denied health service claims through PID’s new Independent External Review process. In total, the external review process overturned 50.1 percent of appealed denials, helping to ensure more Pennsylvanians receive the health services they deserve and marking a strong start for the process’s first year. Click here to learn more about the overturned denials.

The Western Center for Agriculture created this checklist for employers of farmworkers to decrease risk of H5NI exposure.  Available in both English and Spanish, it covers California-specific regulations in addition to guidance on written procedures, sanitation, biosecurity, training, personal protective equipment, and medical care.

In December, the Centers for Medicare & Medicaid Services (CMS) announced four states will participate in the Innovation in Behavioral Health Model (IBH Model). The selected states are Michigan, New York, Oklahoma, and South Carolina. The IBH Model is a collaboration between CMS and state Medicaid agencies to build a model that provides integrated care to Medicaid and Medicare populations with moderate-to-severe mental health conditions and/or substance use disorder (SUD). Model implementation began on January 1, 2025.

– Comment by March 7.  On January 6th, 2025, the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) issued a proposed rule to modify the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Security Rule to strengthen cybersecurity protections for electronic protected health information. The proposal will strengthen the Security Rule’s standards and implementation specifications with new proposals and clarifications. This rule will impact hospitals, providers, health plans, and any other entity that use or transmit electronic protected health information. Comments are due March 7, 2025.