- 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
- Public Inspection: CMS: Medicare Program: Fiscal Year 2026 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements
- Public Inspection: 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 and Medicaid Programs; CY 2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Prescription Drug Inflation Rebate Program; and Medicare Overpayments; and Appeal Rights for Certain Changes in Patient Status; Corrections and Correcting Amendment
- CMS: Request for Information; Health Technology Ecosystem
- CMS: Medicare and Medicaid Programs; CY 2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Prescription Drug Inflation Rebate Program; and Medicare Overpayments; and Appeal Rights for Certain Changes in Patient Status; Corrections and Correcting Amendment
- VA: Staff Sergeant Fox Suicide Prevention Grant Program Funding Opportunity
- State: 60-Day Notice of Proposed Information Collection: J-1 Visa Waiver Recommendation Application
- HHS: Request for Information (RFI): Ensuring Lawful Regulation and Unleashing Innovation To Make American Healthy Again
- Public Inspection: CMS: Request for Information: Health Technology Ecosystem
Reported High Activity of Mycoplasma pneumoniae and Rhino/Enteroviruses in Pennsylvania
Emergency department visits for pneumonia have been increasing, particularly among children and young adults. Some hospitals and college student health centers have reported clusters of cases of pneumonia due to Mycoplasma pneumoniae. National laboratory surveillance for respiratory viruses is also noting an increase in percent positivity for rhinovirus/enterovirus in PA. Testing for respiratory pathogens should be performed to guide appropriate management and treatment. PCR-based molecular tests are preferred for rapid and accurate diagnosis of both M. pneumoniae and rhinovirus/enterovirus. Antibiotics should not be used to treat viral infections. Macrolides are the first line of treatment for M. pneumoniae infections. Macrolide-resistant strains are emerging, but susceptibility testing is not generally available. Consider using tetracyclines or fluoroquinolones if a macrolide does not appear to be effective. Use transmission-based precautions (droplet and contact) to reduce spread in health care and community settings. Promote respiratory hygiene and encourage symptomatic individuals to stay at home. Encourage vaccination for influenza and other respiratory viruses to reduce the risk of co-infections. Report unusual clusters or outbreaks of respiratory illnesses to the Pennsylvania Department of Health by calling 1-877-PA-HEALTH (1-877-724-3258) or your local public health department. Individual cases of M. pneumoniae and rhinovirus infection are not reportable to the Department. The full HAN is available.
New Pennsylvania Bulletin Notification 08-24-15 FQHC/RHC Payment for SARS-CoV-2 Vaccine Administration
The purpose of this bulletin is to advise Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) that the Pennsylvania Department of Human Services is continuing the alternative payment methodology to pay the Medical Assistance Program Fee Schedule rate for the administration of the novel coronavirus (SARS-CoV-2) vaccine during a SARS-CoV-2 vaccine-only visit. In addition, this bulletin contains an updated The PROMISe™ Provider Handbook 837 Professional/CMS-1500 Claim Form, Appendix E – FQHC/RHC Handbook (FQHC/RHC Handbook) to clarify the payment methodology for vaccine-only visits.
Impacts of the New Medicaid Managed Care Rule: Opportunities to Improve Quality and Access
The managed care delivery system has grown to be the primary model for delivering healthcare services to approximately 75% of the Medicaid population. The newest Issue Brief, created in collaboration with Population Health Alliance (PHA), summarizes key provisions from CMS’ 2024 final Medicaid managed care rule. Sellers Dorsey Managing Director Leesa Allen and Director Brian Dees, alongside PHA contributors, assess potential impacts and opportunities for states, MCOs, providers, and solution partners to improve access to and quality of care for Medicaid enrollees. Click here to download the Issue Brief.
Study in JAMA Shows CHCs use 340B to Expand Access, Argues Against “Lumping CHCs in” with Hospitals
The Journal of the American Medical Association Health Forum published a study from the University of Minnesota, which was based entirely on quantitative analysis of UDS and OPAIS (HRSA 340B) data. The article concluded that as FQHCs’ 340B savings increase, they serve a growing number of “total, uninsured and privately insured patient volume, as well as… low-income, unhoused and non–English-speaking populations.” FQHCs also provide “increased provision of health services that aren’t especially profitable for the facilities, but considered valuable preventative care measures, such as tobacco cessation counseling and HIV tests”.
Pennsylvania Auditor General Advocates for Pharmaceutical Reform
Pennsylvania Auditor General Tim DeFoor recently visited Erie to speak with pharmacists locally on the struggles they face and talk about the reform needed. DeFoor released a performance audit in August that outlines how Pennsylvania taxpayers paid $7 million more for Medicaid prescription drug benefits than they should have in 2022. Read more.
Pennsylvania Governor Issues Order on Housing Action Plan and Homelessness
On September 12, Pennsylvania Governor Shapiro’s office announced Executive Order (EO) 2024-03, which outlines a statewide housing action plan on affordable housing aimed at addressing homelessness. The Housing Action Plan will be a data-driven statewide plan with recommendations to the governor for increasing housing supply and supporting the preservation of existing housing.
Maternal Depression Bill Awaits Pennsylvania Governor’s Signature
Legislation intended to help recognize and respond to perinatal and postpartum depression (PPD) is on Pennsylvania Governor Shapiro’s desk. House Bill 2127 directs the Department of Health to centralize information on symptoms and treatment for PPD online and on fact sheets available in doctors’ offices, including an up-to-date list of organizations that provide counseling. The Senate on Tuesday unanimously approved the legislation. The House on Wednesday voted to concur to amendments made by the Senate. Maternal mental health conditions are the leading cause of pregnancy-associated death in the commonwealth, according to the Pennsylvania Maternal Mortality Review Committee. Nearly 75% of mothers affected receive no treatment.
Mobilizing Health Care Workforce via Telehealth
ProviderBridge.org was created through the Coronavirus Aid, Relief, and Economic Security (CARES) Act by the Federation of State Medical Boards and HRSA’s Office for the Advancement of Telehealth. The site provides up-to-date information on emergency regulation and licensing by state as well as a provider portal to connect volunteer health care professionals to state agencies and health care entities.
SAMHSA’s FindTreatment.gov Now Available in Spanish
Designed to serve Spanish-speaking communities, the online tool from the Substance Abuse and Mental Health Services Administration (SAMHSA) offers confidential and anonymous access to nearby treatment facilities and practitioners.
New Report Highlights Strategies for Building, Growing, and Retaining Rural Health Workforce
The report from the National Rural Health Resource Center was done in collaboration with FORHP and is a product of the May 2024 Rural Health Workforce Summit. Each of the report’s four key strategies include specific and practical actions that can be adopted to address workforce shortages.