- 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 Increases Conditions Eligible for Medical Marijuana to 23
Pennsylvania legalized medical marijuana in 2016, allowing it to be used to treat 17 medical conditions. That list has now grown to include 23 conditions. Eligible conditions now include anxiety disorder, ALS, autism, cancer, Crohn’s disease, damage to nervous tissue of the spinal cord, dyskinetic and spastic movement disorders, epilepsy, glaucoma, HIV/AIDS, Huntington’s disease, inflammatory bowel disease, intractable seizures, multiple sclerosis, neurodegenerative diseases, neuropathies, opioid use disorder, Parkinson’s, PTSD, severe chronic or intractable pain, sickle cell anemia, terminal illness and Tourette syndrome. Someone with one of the conditions must have it certified by a doctor who is state-approved to obtain a card enabling them to buy medical marijuana at a medical marijuana dispensary.
Pennsylvania Is a State-Based Exchange Using a Federal Platform for 2020
On July 2, 2019, Pennsylvania Governor Tom Wolf signed House Bill 3 (now Act 42 of 2019) into law to create a state-based exchange (SBE) in Pennsylvania and begin a two-year transition from the current federally-facilitated Marketplace through Healthcare.gov to the SBE. Full transition to the SBE is slated for the 2021 Open Enrollment period and at that time the commonwealth will host its own website, navigator programs, call center and marketing and outreach. For this 2020 transition year, PACHC has been awarded sole state funding to operate the Navigator Program under the Pennsylvania Health Insurance Exchange Authority. Since implementation of the ACA in 2010, Pennsylvania has relied on the federal health insurance exchange. To cover costs, the federal government charged insurers a 3.5 percent fee on premiums paid by ACA enrollees each month, a projected $98 million for Pennsylvania insurers in 2019. This user fee is expected to be cut to 3% beginning in 2020, decreasing the amount to approximately $88 million. Pennsylvania will continue to use Healthcare.gov to enroll consumers for 2020 coverage, to calculate premium tax credits and to enroll consumers eligible for special enrollment periods.
Pennsylvania Awarded Another $75M to Respond to Opioid Epidemic
State and local agencies in Pennsylvania will receive $75 million over the next year to combat the opioid epidemic, part of $1.8 billion in funding the Trump administration announced Wednesday. The new round of funding includes $8.5 million to the Pennsylvania Department of Health, $5.9 million to the Philadelphia Department of Public Health and $5.2 million to the Allegheny County Health Department to better collect and track overdose data as close to real time as possible. The state intends to use the money to help overwhelmed county offices and find ways to streamline data collection into a standardized statewide system. This new money to support opioid reporting is in addition to the nearly $56 million the state will receive in the next year to carry out its opioid response plan.
Pennsylvania Awarded $2.25 Million to Study Maternal Mortality
The administration of Pennsylvania Governor Tom Wolf announced that it has received a $2.25 million grant from the Centers for Disease Control and Prevention to study the cause of maternal deaths in the state after an increase in recent years. Read more.
Pennsylvania Department of Human Services Announces Suicide Prevention Task Force Public Listening Sessions
On May 29, 2019, Pennsylvania Governor Wolf’s administration announced the creation of a statewide Suicide Prevention Task Force. The goal of this task force is to bring together state agencies with differing responsibilities and constituencies to inform a comprehensive, statewide suicide prevention plan.
Suicide does not discriminate, and all ages, genders, regions, and socioeconomic statuses may be affected. Because of this, the task force is seeking public input on their ideas for suicide prevention, education around mental health and suicide, and how to dispel the stigma around suicide and mental health.
Public listening sessions will take place around the commonwealth beginning in September through November. Sessions are currently scheduled for:
- Thursday, September 12, 5:30-7:30 p.m. – Penn State Behrend – Erie, PA
- Thursday, September 26, 5:30-7:30 p.m. – Temple University – Philadelphia, PA
- Thursday, October 10, 5:30-7:30 p.m. – Jewish Community Center – York, PA
- Thursday, October 24 – 5:30-7:30 p.m. – Scranton/Wilkes-Barre Area – Additional Details Coming Soon
- Friday, October 25 – 10 a.m.-12 p.m. – Allentown – Additional Details Coming Soon
- Thursday, November 7 – 5:30-7:30 p.m. – Jewish Healthcare Foundation – Pittsburgh, PA
- Friday, November 8 – 10 a.m.-12 p.m. – Slippery Rock University, Slippery Rock, PA
- Friday, November 15 – 10 a.m.-12 p.m. – Southeastern Pennsylvania – Additional Details Coming Soon
You can register for the listening sessions here. Please complete one registration per participant from your organization or family. If you would like to speak, please indicate that on your registration. Additional details on locations and parking will be sent ahead of each event.
Shortage Designation Modernization Project: Auto-HPSA National Update
On August 30, 2019, HRSA updated all automatically designated Health Professional Shortage Area (Auto-HPSA) scores. With the implementation of this update, for the first time Auto-HPSAs are now scored electronically, not manually, streamlining the process and ensuring that all HPSAs nationwide are in a single online system.
All Auto-HPSA organizations have the opportunity to submit rescore requests via the online Auto-HPSA portal.
Updated scores will be used for the FY 2020 National Health Service Corps (NHSC) Loan Repayment Program application cycle, which will open in February 2020.
View the announcement and visit the Shortage Designation Modernization Project for more information about the update.
National Health Service Corps Partners with SAMHSA’s Providers Clinical Support System
A new partnership between our National Health Service Corps (NHSC) and SAMHSA’s Providers Clinical Support System (PCSS) connects qualified clinicians to free Medication-Assisted Treatment training and professional development resources, and the opportunity to obtain the DATA 2000 Waiver, which will increase access to quality substance use disorder or opioid use disorder treatment in rural and underserved areas.
HHS Announces $1.8 Billion in New Funding to States to Combat Opioid Crisis
On September 4, 2019, the U.S. Department of Health and Human Services (HHS) announced more than $1.8 billion in funding to states to continue the Trump administration’s efforts to combat the opioid crisis by expanding access to treatment and supporting near real-time data on the drug overdose crisis.
The Centers for Disease Control and Prevention (CDC) announced more than $900 million in new funding for a three-year cooperative agreement with states, territories, and localities to advance the understanding of the opioid overdose epidemic and to scale-up prevention and response activities, releasing $301 million for the first year.
The Substance Abuse and Mental Health Services Administration (SAMHSA) awarded approximately $932 million to all 50 states as part of its State Opioid Response grants. By the end of 2019, HHS will have awarded more than $9 billion in grants to states and local communities to help increase access to treatment and prevention services since the start of the Trump administration.
The full CDC state by state data table is here
The full SAMHSA state by state table is here
CMS Revamps Medicare Plan Finder
During the week of August 26, 2019, the Centers for Medicare and Medicaid Services (CMS) announced that it launched a redesigned Medicare Plan Finder that aims to make it easier for Medicare beneficiaries to compare their coverage options. CMS said the update to the Medicare Plan Finder is the first in a decade and is part of the agency’s eMedicare initiative, “which expands and improves on current Medicare consumer service options.”
Rural Guide to Improving Chronic Obstructive Pulmonary Disease Care (COPD)
A policy brief issued last year by the University of Minnesota reported that while the COPD prevalence rate is higher for individuals living in rural areas, Critical Access Hospitals are less likely to employ any respiratory therapists. With support from HRSA’s Federal Office of Rural Health Policy, the National Rural Health Resource Center created this guide to help rural hospitals and clinics identify areas for improvement with diagnosis, treatment, and long-term care of COPD patients. The guide is developed as part of the COPD National Action Plan, with the goal of developing resources for improving the lives of patients living with COPD in rural communities. Click here to access the full brief.