The Pennsylvania Insurance Department (PID) announced that it has fined Aetna $190,000 and UnitedHealthcare $1 million for violating health insurance parity laws, including those requiring that coverage for substance use disorders and mental health be offered at the same level of benefits as medical or surgical treatment. Violations included incorrect application of copays, coinsurance, and visit limits, as well as violations involving prior authorization for treatment according to a news release. PID previously fined Blue Cross of Northeastern Pennsylvania $90,000. PID said it plans to examine all major health insurers in the commonwealth to ensure that they are in compliance with the parity laws.
Mental Health America Ranks Pennsylvania Number One
Mental Health America has released their state by state report on mental health care. Pennsylvania is ranked number one in the nation in State of Mental Health in America. The access measures include access to insurance, access to treatment, quality and cost of insurance, access to special education, and workforce availability. A high access ranking indicates that a state provides relatively more access to insurance and mental health treatment.
What Does Google Health Have Planned?
David Feinberg, a physician from Geisinger Health and former President and CEO of Geisinger, joined Google to lead its newly created Google Health division last year. At the recent HLTH conference, one of the largest and most important conferences for health innovation, Dr. Feinberg said that one idea would be to focus efforts on Google’s core expertise in search, looking to make it easier for doctors to search medical records. He also wants to improve the quality of health-related search results for consumers, so results are more authoritative across Google and YouTube. “Imagine a search bar on top of your EHR that needs no training,” he proposed. Here’s how he explained it: Doctors could start typing into the search bar, just as they do when searching for answers on Google, and the system would start automatically filling out responses and offering up information. He offered the example of a doctor typing in the number “87” and the system then auto-completes information on the 87-year-old patient with a history of stomach cancer.” Read more.
Court Voids “Conscience Protection Rule”
On November 6, 2019, the District Court in New York voided the Trump administration’s “conscience protection rule” that allowed healthcare providers to refuse to participate in abortions, sterilizations, gender-reassignment, hormonal birth control, and other procedures they disagree with on religious or moral grounds. Opponents of the rule, which was scheduled to go into effect on Nov. 22, argued that it would disproportionately harmed certain groups of patients, including LGBTQ patients. In citing the need for the new rules, HHS cited the case of a nurse midwife who sued a Florida health center that would not hire her for a Title X-funded position due to her objection to prescribing hormonal birth control. While the District Court decision will likely be appealed to the Circuit Court, the ruling means that the new regulation will not go into effect for the foreseeable future.
CONNECT for Health Proposes Fewer Barriers to Telehealth for Medicare Beneficiaries
During the week of November 4, 2019, six U.S. senators re-introduced bipartisan legislation, the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2019, to improve health outcomes, make it easier for patients to connect with physicians, as well as help cut costs for patients and providers by eliminating barriers to the use of telehealth services for Medicare beneficiaries. It would: provide the Secretary of Health and Human Services with the authority to waive telehealth restrictions when necessary; remove geographic and originating site restrictions for services; allow rural health clinics and federally qualified health centers to provide telehealth services; and require a study to explore ways to expand telehealth so people could access healthcare in their homes. The legislation has been endorsed by more than 120 organizations such as the American Hospital Association, the Healthcare Information and Management Systems Society, and the National Association of Community Health Centers. Companion legislation has been introduced in the House of Representative. Read more.
Pennsylvania DHS Releases Preliminary MATP Report
On October 28, 2019, the Pennsylvania Department of Human Services (DHS) released a preliminary report that reviews financial data, studies, and surveys related to the Medical Assistance Transportation Program (MATP) and non-emergency medical transportation brokerage programs. Per a legislative directive, DHS developed a MATP Analysis Workgroup to study the state’s shift to a brokerage model. The report outlines the data sources used as the foundation of the analysis and how the workgroup is seeking stakeholder feedback. The final analysis is scheduled for completion by December 28.
The Effects of Childhood Trauma
Traumatic childhood experiences are associated with higher odds of developing some of the leading causes of death later in life, according to a CDC report published this week. Overall, CDC estimated that eliminating childhood trauma could prevent 1.9 million cases of coronary heart disease, 2.5 million cases of obesity, and 21 million cases of depression. (Source: Associated Press, 11/5)
Health in the United States
The United States has seen decreases in life expectancy and increases in obesity and drug overdose rates, as well as steadily increasing overall health care costs, according to a recent report from CDC’s National Center for Health Statistics that spotlights the state of health in the country. For example, the report found that average life expectancy at birth decreased to 78.6 years in 2017, from 78.7 years in 2016. (Source: Axios‘ “Vitals,” 10/30)
Human Trafficking and Public Health – New SOAR Online Training Module
SOAR Online is a series of training modules launched in 2018 by the National Human Trafficking Training and Technical Assistance Center and Postgraduate Institute, in collaboration with federal partners. A new SOAR for School-Based Professionals Module equips those serving middle and high school students to better understand how human trafficking-related issues impact youth. Visit the SOAR Online page for full CE/CME information and register for SOAR Online.
Pennsylvania Governor Wolf’s Administration Establishes Links for Continuity of Care for Pennsylvanians Reentering Their Communities
The Pennsylvania departments of Human Services (DHS) and Corrections (DOC) today announced that all of DOC’s state-run correctional facilities are connected to DHS’ Pennsylvania Patient & Provider Network (P3N). This marks a significant milestone in the commonwealth’s ability to help individuals to maintain continuity of their medical care before, during and after incarceration in a Pennsylvania state prison.
“DOC’s connection to the P3N will have a positive impact on health care for incarcerated and returning citizens by enabling the electronic sharing of information with thousands of health care providers connected to the five existing P3N certified Health Information Organizations (HIO) in Pennsylvania,” said DHS Secretary Teresa Miller. “This will bridge connections between care received while incarcerated to help returning citizens on their paths to healthy and productive lives.”
“Our charge every single day is to provide our inmate population with health care services that meet or exceed community standards,” said DOC Deputy Secretary for Administration Christopher Oppman. “Having immediate access to past medical records gives us the ability to provide timely, comprehensive care, which benefits the inmate and his/her health. Similarly, being able to provide critical information to outside health care providers upon release also ensures continuity of health care services and successful reentry back into the community.”
When an individual first enters an SCI, that facility will access that person’s medical data via the P3N to review the treatments and services they received from health care providers prior to their incarceration. This will give the correctional facility a better picture of a new inmate’s clinical history so that they can provide appropriate follow-up care while the person resides in that SCI.
Health care providers who are treating and caring for reentrants are also able to access vital information that providers should know when making clinical decisions. P3N network participants across the commonwealth will be able to access DOC’s patient information about treatments and services that individuals received during their periods of incarceration in a state correctional institution (SCI).
In addition to maintaining continuity of care, this bi-directional information exchange between DOC and the P3N also reduces the amount of time needed to access vital patient data and lowers costs by reducing duplicative tests and services.
Through this partnership with DHS, the DOC’s connection to the P3N gives SCI medical personnel the data needed to treat and serve new inmates. In addition, community health providers can better serve reentrants who have become their patients, helping them to achieve better health outcomes.
The P3N was established through Act 76 of 2016 to create a means of communication between health care providers, payers and patients. It creates efficiencies in health care delivery and promotes improved health outcomes for patients. The P3N links health information organization (HIO) member organizations to providers and payers across the state improving health care in their communities through increased coordination and communication between providers.
In July, Governor Tom Wolf signed an executive order strengthening protections for vulnerable populations such as re-entering citizens. As part of this effort, the administration is committed to supporting innovation in work and information sharing between agencies and our partners in the private sector. This expanded network of information sharing will help health care providers working in the SCIs and communities have more complete pictures of reentering citizens’ medical histories and do more to address their needs and barriers to good health.
For more information on the Department of Human Services, visit www.dhs.pa.gov.
For more information on the Department of Corrections, visit www.doc.pa.gov.