Pennsylvania Gov Wolf: Medicaid and CHIP Recipients’ COVID-19 Testing and Treatment Resources are Covered

Harrisburg, PA – March 11, 2020.  Governor Tom Wolf announced that the state’s Medicaid program, Medical Assistance (MA) and Children’s Health Insurance Program (CHIP), will cover COVID-19 testing and treatment for recipients and is lifting some prior authorization requirements to ease access to necessary testing and treatment. There are no MA or CHIP copayments for laboratory tests for COVID-19. For those services that do have copayments, MA providers may not deny services if a beneficiary is unable to pay the copayment.

“We are prepared to mitigate COVID-19 throughout the commonwealth, and part of this mitigation includes ensuring that anyone who needs to be tested for COVID-19 can access the test,” said Governor Tom Wolf. “No Pennsylvanian should forego testing for any reason, if deemed medically necessary, including fear of what it might cost.”

The MA and CHIP programs will pay for COVID-19 testing when a health care practitioner determines it is needed, and prior authorization is not required. While there is no specific antiviral treatment for COVID-19, the MA and CHIP programs cover a broad range of services that help relieve symptoms.  

The Department of Human Services reminds Pennsylvanians that Medicaid enrollment is year-round and if anyone is currently uninsured, they should go to compass.state.pa.us to see if they qualify for Medicaid.

“We are pleased to make this announcement today and thankful to our partners at the Centers for Medicare for Medicaid Services and our managed care organizations for working with us to ensure that anybody who needs to be tested for COVID-19 will have no barriers to the test,” said DHS Secretary Teresa Miller.

Providers and patients can consult the Medicaid FAQ and CHIP FAQ for more information and answers to common questions related to medical assistance coverage and COVID-19 and information on who to contact if consumers need more information.

The Wolf Administration recently released guidance through the Pennsylvania Insurance Department outlining resources available and coverage for COVID-19 testing through commercial health insurers. Read more on common questions related to commercial insurance coverage and COVID-19 here.

Visit the PA Department of Health’s dedicated Coronavirus webpage for the most up-to-date information regarding COVID-19.

MEDIA CONTACT:    Lyndsay Kensinger, 717-783-1116
Erin James, 717-425-7606

Pennsylvania Update on COVID-19 in Community

On March 11, 2020, the Pennsylvania Department of Health morning confirmed three additional presumptive positive case of COVID-19 – two residents from Bucks County and one from Montgomery County. All are adults and in isolation at home. This brings the statewide total to 15 cases; 13 of the cases are presumptive positive and two cases, the Delaware County and Wayne County cases, have been confirmed by the CDC.

“While we anticipate that there will be more Pennsylvanians with COVID-19 in the coming days and weeks, it is important for residents to know the commonwealth is prepared and to be prepared themselves,” Secretary of Health Levine said. “Right now, you have a higher chance of testing positive for COVID-19 if you have traveled to a country or state with known community outbreaks or have come in contact with someone who has the virus. We are working with the health care community across Pennsylvania to keep them informed, consult on patient testing and ensuring they have the resources they need to care for patients.”

It is crucial to avoid spreading misinformation. Below are confirmed sources for accurate and factual information and updates.

Pennsylvania Department of Health

The Pennsylvania Department of Health is working diligently to monitor the COVID-19 situation in Pennsylvania and share information. Updates continue to be posted regularly DOH coronavirus webpage.  The Department of Health is beginning daily press briefings on COVID-19 at noon every day. These briefings are livestreamed on PAcast. The link will be the same every day.

Center for Disease Control & Prevention (CDC)

The CDC COVID-19 webpage offers a wealth of information and resources on outbreak in the United States. Information on the disease, situation updates, and specific information for travel and professionals is available and updated as needed.  The Pennsylvania Department of Health works in collaboration with the CDC for factual material.

Ready PA

Ready PA has the information to prepare by learning about:

  • Different kinds of emergencies
  • How to create all hazards/emergency plans and kits for your home, vehicle, and workplace
  • How to plan ahead if you have a special need

The Wolf Administration Preparedness Actions

The World Health Organization first announced the coronavirus outbreak in late January and the Pennsylvania Department of Health has had its Emergency Operations Center set up since February 1. The center allows for a collaborative, concentrated state response, including:

  • Activated the Department of Health’s Emergency Operations Center to allow for enhanced response coordination;
  • Begun testing for COVID-19 at the state laboratory;
  • Maintained communication and outreach with federal, state and local partners;
  • Provided symptom monitoring for residents returning from areas impacted by coronavirus;
  • Provided health care providers, businesses and education providers with information;
  • Reviewed and adapted current pandemic flu plans to prepare for spread of COVID-19;
  • Increased testing capacity;
  • Partially activated the Commonwealth Response Coordination Center at PEMA.
  • Governor Tom Wolf signed an emergency disaster declaration March 6 to ensure state agencies involved in the response have the expedited resources they need to continue to focus on the virus and its possible spread.
  • The Department of Health is providing a daily update via statewide press release.
  • On March 9, Sec. of Health Dr. Rachel Levine began to provide daily press briefings. 
  • CDC confirmed two cases, one in Delaware County and one in Wayne County. This means Pennsylvania has 13 presumptive positive cases and two positives.

Rural Hospital Guide to Improving Care Management

The Technical Assistance and Services Center (TASC), a program of the National Rural Health Resource Center (The Center), is pleased to share the Rural Hospital Guide to Improving Care Management.

The Rural Hospital Guide to Improving Care Management is a result of the 2019 Rural Care Coordination and Population Health Management Summit, funded by FORHP. The guide provides rural hospital executive and management teams with generally accepted best practice concepts related to care management. Rural hospitals can use the guide to determine how to most effectively staff care management and identify opportunities to improve clinical and financial outcomes.

State rural health partners may also benefit from this guide, as it assists them in asking the right questions when meeting with hospital leadership. The guide also offers opportunities to improve performance within the hospital setting through the transition from traditional fee-for-service reimbursement to a value-based, population-health-focused reimbursement environment.

The 2019 Rural Care Coordination and Population Health Management Summit Report will assist rural hospitals, clinics, and network leaders in considering key actions they can undertake to incorporate community care coordination planning as a strategy to help position their organization for population health.

Visit the TASC resource library to gain access to the Rural Hospital Guide to Improving Care Management and learn more about the Rural Hospital Care Coordination and Population Health Management Summit Report. You may also view the accompanying video: Population Health for Rural Hospitals: What the experts are saying, featuring Summit panelists.

Access the guide and summit report here.

New Fact Sheet Highlights National Rural Health Day Impact

National Rural Health Day continues to be successful because of support from the members of the National Organization of State Offices of Rural Health (NOSORH) and their partners. NOSORH is proud of the reach and impact this program has year after year as we work to bring new programs, ideas, events, and opportunities to celebrate the #PowerofRural – 2019 was no exception!  Check out the new fact sheet that highlights the impact of National Rural Health Day 2019 at the local, state and national level:  National Rural Health Day Impact Fact Sheet

Report Explores Teledentistry in Rural Areas

A new report published in the National Conference of State Legislatures found that rural Americans are more likely to experience tooth decay than their urban counterparts. The report explores teledentistry as a solution to addressing the disparity and discusses states that have already introduced legislation to establish teledentistry and expand access to oral health services.

Click here to download the report.

HHS Finalizes Interoperability Rules

On March 9, 2020, the U.S. Department of Human Services (HHS) finalized two transformative rules that will give patients unprecedented safe, secure access to their health data. Interoperability has been pursued by multiple administrations and numerous laws, and today, these rules finally deliver on giving patients true access to their healthcare data to make informed healthcare decisions and better manage their care. Putting patients in charge of their health records is a key piece of giving patients more control in healthcare, and patient control is at the center of the Trump administration’s work toward a value-based healthcare system.

The two rules, issued by the Office of the National Coordinator (ONC) and the Centers for Medicare and Medicaid Services (CMS), implement interoperability and patient access provisions of the bipartisan 21st Century Cures Act (Cures Act) and support President Trump’s MyHealthEData initiative. MyHealthEData is designed to empower patients around a common aim – giving every American access to their medical information so they can make better healthcare decisions.

To read the HHS press release, please visit: https://www.hhs.gov/about/news/2020/03/09/hhs-finalizes-historic-rules-to-provide-patients-more-control-of-their-health-data.html

For more information on the ONC final rule, please visit: https://protect2.fireeye.com/url?k=f38dbe61-afd9974a-f38d8f5e-0cc47a6d17cc-bffa0ac2011a7cad&u=https://healthit.gov/curesrule

For more information on the CMS final rule, please visit: https://www.cms.gov/newsroom/fact-sheets/interoperability-and-patient-access-fact-sheet

To view the CMS final rule, please visit: https://www.cms.gov/Regulations-and-Guidance/Guidance/Interoperability/index

To view the ONC final rule, please visit: https://protect2.fireeye.com/url?k=f9e21b2d-a5b63206-f9e22a12-0cc47a6d17cc-f19fbf5cef959860&u=https://healthit.gov/curesrule

Fighting for Health Care: Rural America Struggles with Loss of Doctors, Clinics

U.S. Today, March 6, 2020

FAIRFIELD, Washington — Drive 20 minutes south of Spokane and pine trees give way to rolling hills, which in fall are golden with remnants of the wheat harvest and in winter dusted with snow. This part of eastern Washington state is the beginning of the Palouse region. Its small farm towns once thrived but now struggle to offer essential services such as health care.

For decades in Fairfield, residents received care from a doctor in a community clinic on Main Street. Alongside a post office, community center (which doubles as Town Hall), drug store, bank and library, a stucco building where the health clinic used to be sits vacant.

Longtime Fairfield residents recall giving birth to their children at the clinic and visiting for regular checkups. But in 2019, after Kaiser Permanente acquired the health care group that operated the clinic, it closed and the doctor moved to Spokane, a 30-minute drive north.  The drive is reasonable for some Fairfield residents, but it’s not feasible for others. As the Spokane-based Spokesman-Review reported, the majority of residents at Palouse Country Assisted Living, one of Fairfield’s largest employers, cannot drive.

Nationally, more than one in five people over age 65 live in rural areas, Census data show, and in Washington state, 20 percent of people 65 and older live in rural communities.

Read more.