Following a nationwide search, the Pennsylvania Health Insurance Exchange Authority (Pennie) Board of Directors has named Devon Trolley as the next Executive Director of Pennie. Zachary Sherman, Pennie’s inaugural Executive Director, will be stepping down at the beginning of March after more than three years in the role. Devon joins Pennie with extensive Affordable Care Act policy, operational, and leadership experience. Prior to her tenure in New Jersey, Trolley worked for the federal government at the Centers for Medicare and Medicaid Services (CMS) on the implementation and stabilization of the federal health insurance marketplace (Healthcare.gov) in key strategic and policy roles. She also served as a Senior Advisor in the Office of the CMS Administrator working to address the opioid crisis and improve maternal health. Trolley developed health policy in the United State Senate during the passage of the Affordable Care Act in 2010 and is an alumna of Penn State University.

As the Pennsylvania Department of Human Services (DHS) begins the Medicaid Continuous Coverage unwinding April 1, DHS is working in conjunction with PA’s health insurance exchange, Pennie, to minimize the number of people who may become uninsured or fall into the coverage gap. There has been an increase of over 820,000 Medicaid enrollments since March 2020 to over 3.6 million due in part to the continuous coverage provision. Some things to keep in mind as Medicaid redeterminations begin:

•  The number of recipients churning on and off Medicaid decreased as those likely ineligible for Medicaid remained on the rolls. When “normal” renewal and redetermination processing begins, consumers who are deemed ineligible and have coverage terminated will need to appeal and/or request a redetermination within 90 days. Consumers who have coverage terminated will keep coverage under their current Medicaid managed care organization (MCO) until the end of the month.
•  Health centers should collaborate with MCOs on outreach to assist consumers with renewals and assistance with enrolling in Pennie, if deemed eligible. Health centers must also rely on health insurance enrollment assisters, eligibility and financial counselors and front desk staff to ensure processes and procedures are in place to identify and remind Medicaid patients to update their demographic information with DHS and their HealthChoices MCO. Consumers can renew over the phone at 1-866-550-4355, complete their renewal online in COMPASS, by mail, or in-person at the county assistance office.

On January 5, 2023, the Centers for Medicare and Medicaid Services (CMS) released an Informational Bulletin that included timelines for states to submit a renewal redistribution plan, system readiness plans and results, and baseline unwinding data based on when states plan to begin renewals. Along with enhanced reporting requirements, states are required to report the total number of individuals renewed and those renewed on an ex parte basis, break out Medicaid terminations for children’s coverage and pregnancy-related coverage, report the number of individuals whose coverage was terminated for procedural reasons, and report total call center volume, average wait time, and average abandonment rate. Pennsylvania’s lowest uninsured rate was 5.5% but this number is expected to increase over the next 12 months.

On January 26, the Centers for Medicare & Medicaid Services (CMS) revised Chapter 13 of the Medicare Benefit Policy Manual to include payment policy for Rural Health Clinics and Federally Qualified Health Centers as finalized in the CY 2022 and CY 2023 Physician Fee Schedule Final Rules. Key updates can be found in the CMS Medicare Learning Network (MLN) Connects newsletter.

Last week, the Drug Enforcement Administration (DEA) announced proposed rules for the prescribing of controlled medications via telemedicine beyond the end of the COVID-19 public health emergency. One rule addresses the expansion of induction of buprenorphine via telemedicine encounter while the other covers telemedicine prescribing of controlled substances when the practitioner and the patient have not had a prior in-person medical evaluation. While opioid use disorders occur at similar rates in both rural and urban areas, medication-assisted treatment (MAT) prescribers have been disproportionately located in urban areas. Comments are due by March 31, 2023.

The Health Resources and Services Administration (HRSA) relies on grant reviewers to select the best programs from a competitive group of applicants. Over the coming months, the Federal Office of Rural Health Policy will be competing a number of programs, including among other things: substance use disorders and opioid use disorder, rural workforce, and rural hospitals. Having reviewers with expertise in rural health greatly benefits the review process and is also an opportunity to learn about the review process itself. Reviews are typically held remotely over a period of a few days and reviewers who participate and complete their assigned duties receive an honorarium. Registration is easy and does not commit you to serving as a reviewer. Please consider lending your expertise to these important initiatives.

  The Economic Research Service (ERS) at the U.S. Department of Agriculture released updates to its data on socioeconomic indicators such as poverty rates, population change, unemployment rates, and education levels.  ERS State Fact Sheets, which show numbers comparing rural and urban, were also updated to add estimates on educational attainment.

  In February of last year, the U.S. Department of Agriculture (USDA) launched an effort focused on removing barriers to federal programs within the agency’s mission.  The announcement named historical discrimination – racial, and also geographic, social, and economic – it intends to address with a newly formed Equity Commission.  In the year before, USDA made a Request for Information from the public and held five public listening sessions, asking for feedback on customer experience with USDA programs.  The response pointed to a history of discrimination, barriers to funding and land, and loss of trust with Indian Tribes among several other findings that have become priorities for the equity initiative.  Earlier this week, the Equity Commission released its first set of recommendations.  These and information about other efforts can be found at www.usda.gov/equity.