As an extension of PACHC’s benefits to health centers, we partner with Commonwealth Group Purchasing (CPG), a group purchasing organization developed by and for Community Health Centers. CPG provides vetted vendors and cost savings leveraged through group purchasing. There is a no-obligation service to help you assess your current purchasing from medical and business suppliers to current needs in telehealth and recruitment solutions. To learn more, click here or contact Julie Korick, PACHC Chief Operations and Finance Officer
Registration Open for NACHC Financial Operations Training
NACHC’s training workshop, Financial Operations Management 2 (FOM2), is an intermediate-level workshop that provides insight and understanding of the core qualities needed to approach the business aspects of financial operations, management, and service delivery. This is an intermediate-level seminar approved for up to 11.4 CPE credits. The FOM2 training agenda is packed with the essential financial management tools and techniques to help empower health center CFOs, CEOs, COOs and managers to maximize financial performance, engage in contract negotiations and leverage technology for better decision-making. Learn more and register for this May 25-26 virtual training. Early bird registration ends May 11, 2022.
COVID-19 Vaccine Payment Bulletin
The PA Department of Human Services (DHS) has finally released the long-awaited Medical Assistance Bulletin outlining payment for administration of COVID-19 vaccine during a vaccine-only visit in which no other services are provided on the same date. The bulletin announces DHS is implementing an alternative payment methodology (APM):
- To pay the MA Program Fee Schedule rate for the administration of the vaccine on or after Dec. 1, 2020
- To pay the enhanced MA Program Fee Schedule rate for the administration of the vaccine to homebound MA beneficiaries during a vaccine-only visit for dates of service on or after April 1, 2021
It is important to note that the bulletin applies to fee-for-service only; providers rendering services to MA beneficiaries in the managed care delivery system (HealthChoices) must utilize the COVID-19 vaccine administration codes for DHS tracking purposes but must contact the managed care organization (MCO) with billing questions. The bulletin outlines the procedure codes for administration of the vaccine, which are distinct to each COVID vaccine and the specific dose in the required schedule. In order to bill under this new APM, a request to opt in to the APM as of Dec. 1, 2020, must be submitted by the FQHC/RHC chief financial officer (CFO) via email to DHS at financialgatekeeper@pa.gov within 30 days of issuance of the bulletin (by March 26, 2022) and must include both the FQHC/RHC nine-digit service location number for which the opt-in is to be applied. The email should indicate the FQHC/RHC is accepting the APM. Claims submitted within 60 days of the issuance of the bulletin (April 25, 2022) will not be subject to the time frames for submission of claims in 55 Pa. Code §1101.63(b). Read the full bulletin.
HRSA Makes Changes to Health Center COVID-19 Survey
Beginning with the Health Center COVID-19 Survey issued on Feb. 24, HRSA will add new options for questions 7b and 8b. These questions ask where health centers distributed N95 masks and test kits received through HRSA’s COVID-19 Response Programs. Here are the new options:
- Provided to migratory/seasonal agricultural workers directly or through partnerships with community organizations serving these individuals
- Provided to individuals with limited English proficiency directly or through partnerships with community organizations serving these individuals
- Provided to older adults and/or individuals with disabilities directly or through partnerships with community organizations serving these individuals
- Provided to school-age children and/or their families directly or through partnerships with schools
Provided to individuals living in HUD-assisted housing and/or individuals experiencing homelessness directly or through partnerships with local housing authorities
Public Charge Proposed Rule Published
The Department of Homeland Security (DHS) announced that it is publishing a Notice of Proposed Rulemaking (NPRM, or proposed rule) around Public Charge. “Public charge” refers to the factors that immigration officials consider when determining if a legal immigrant should be approved for a Green Card; use of certain public benefits is one of these factors. In general, the NPRM proposes to establish in regulation the Public Charge standards that were in place from 1999 through 2018. Under these standards, the only public benefits that may be considered in a public charge determination are cash assistance and institutional long-term care. In 2018, the Trump Administration expanded the list of public benefits to include use of Medicaid, SNAP, and certain housing supports. The Biden Administration withdrew the Trump regulation in 2021, and now is seeking to enshrine the previous standards in regulations as, to date, these standards exist only in sub-regulatory guidance, and therefore can be easily withdrawn without public input.
Barriers to Medicaid and CHIP Enrollment
The Biden Administration has announced a Request for Information (RFI) related to healthcare access through Medicaid and the Children’s Health Insurance Program (CHIP). The RFI’s aim is to better understand barriers to enrollment. A list of questions to inform responses is available and responses are due by April 18, 2022.
Pennie Assisters
Pennie has helpful quick reference guides and tools available at www.agency.pennie.com/assisters. Bookmark this page for tips and easy access to assister-specific materials. The latest addition is the Special Enrollment Period Quick Reference Guide. The guide provides detailed information on all special enrollment period effective dates, needed documentation and self-attestation rules. This guide and other Qualifying Life Event instructions are available on the Feb. 18 Pennie Lunch and Lunch.
2022 Outreach and Enrollment Peer Networking
PACHC’s February 2022 Outreach and Enrollment Peer Networking call was recorded and is available on our Outreach and Enrollment Slack page. Topics of discussion included Final Open Enrollment 2022 Pennie numbers, assister reporting, upcoming trainings and Medicaid enrollment. Be sure to review the recording for observations, trends and news. Questions, contact Tia Whitaker, Statewide Director, Outreach and Enrollment.
Supreme Court Won’t Hear Challenge to State Mask Mandate
The Supreme Court again rejected an opportunity to hear arguments in a lawsuit that sought to challenge Maine’s COVID-19 vaccine mandate for healthcare workers. The Supreme Court had already rejected the Maine challengers in October, when, over three dissents, the justices refused to intervene on an emergency basis. Maine is one of three states, along with New York and Rhode Island, that require vaccination of healthcare workers and allow exemptions only for medical reasons. Although the Supreme Court has limited the federal government’s power to require COVID-19 shots or tests, the justices have allowed state and local mandates, even without religious exemptions. The court left in force New York’s requirement in December.
Do Your Part to Protect 340B Program
Please keep up your efforts to expand the list of PROTECT 340B cosponsors. We’re told that the current list of 71 cosponsors “is definitely getting the Senate’s attention.” With the possibility of Congress addressing other 340B issues, it becomes even more important to show support for the protections for covered entities in this bill. Here are resources to support your advocacy:
- PROTECT 340B toolkit
- Text of H.R. 4390, the PROTECT 340B Act
- Two-page overview of issue and bill
- Spreadsheet with detailed info on each House member
- List of co-sponsors
There are currently five Pennsylvania co-sponsors: Reps. Matt Cartwright, Glenn Thompson, Dwight Evans, Susan Wild and Fred Keller.