With Medicare and Medicaid reimbursements on the horizon for services provided by Community Health Workers (CHWs), now may be a good time for organizations to consider hiring CHWs to assist patients/clients in accessing needed health and human services. Organizations hiring new-to-the-field CHWs can provide a full year of professional development to their CHWs by participating in Pennsylvania AHEC’s new state registered CHW Apprenticeship Program. Throughout the year, apprentices receive CHW training from Pennsylvania AHEC, structured on-the-job training, and intentional mentorship and supervision. At the end of the year, apprenticeship graduates will be qualified to be certified by the Pennsylvania Certification Board. Certification is expected to be a requirement for CHW services to be reimbursed. For more information, contact PA AHEC Program Manager Amanda Taylor Gehman.

1. How many people are currently on Medicaid in Pennsylvania? According to the most recent data from the PA Department of Human Services, as of December 2023, there are 3,287,641 million Medicaid recipients enrolled in the program.
2. How many have lost coverage since the end of the Medicaid Continuous Coverage requirement ended? Over 420,000
3. What is the transition plan once a beneficiary is no longer eligible for Medical Assistance? Will the transition be seamless to the beneficiary?

• When an individual’s Medical Assistance eligibility is terminated, they are sent a notice indicating why they were found to no longer be eligible and information on their appeal rights. If the closure is for a procedural reason, they may provide the missing information for up to 90 days after the case has closed and have their eligibility reconsidered and their case opened back to the date of closure if they are found to be eligible.
• If an adult is found to no longer be eligible for Medical Assistance due to financial reasons, they may be eligible for subsidized health care coverage on Pennie. Their case information is transferred automatically to Pennie and Pennie conducts outreach to the household with information about their coverage options and the level of subsidy they are eligible for.
• If a child is found to no longer be eligible for Medical Assistance due to financial reasons, they may be eligible for CHIP and will be transitioned into a CHIP category.

Pennie and the Pennsylvania Department of Revenue collaborated to connect uninsured tax filers to coverage through the Path to Pennie program. When uninsured tax filers complete their Pennsylvania state income tax return, they can fill out Tax Form REV-1882 – Health Insurance Coverage Information Request. The PA Department of Revenue will send the information provided on the form to Pennie to create an account. Pennie will then send a notice with three important pieces of information: an access code to open the newly created Pennie account; an estimate of financial assistance the consumer is likely to receive; and a 60-day Special Enrollment Period to apply, shop, and enroll in coverage.

Last summer, a group of six bipartisan Senators (called “the G6” for short) released a Request for Information (RFI) around several aspects of the 340B program. Last week, the G6 released a 50-page discussion draft of a bill for comprehensive 340B reform, entitled the SUSTAIN Act.

• Here is a link to a two-page overview of the 340B reform bill by the bipartisan group of six Senators, with a focus on issues of interest to FQHCs and Primary Care Associations (PCAs).
• A nine-page summary and explanation of the draft bill.
• A supplemental Request for Information by April 1 (incorporated into the summary document) around three of the most significant 340B issues: Contract Pharmacies; Patient Definition; and Hospital child sites.
• A letter to stakeholders that includes the following statement “We believe it is necessary to pass legislation in the 118th Congress that provides clarity, transparency, and accountability in the 340B program in order to ensure the program remains strong, long into the future.”

The balance of the Pennsylvania House is on the line for a fourth time in less than a year, with a special election next week in Lower Bucks County. Two candidates are running to replace longtime Democratic Rep. John Galloway, who resigned to become a magisterial district judge. The outcome of the Feb. 13 election will determine which party controls the House, currently tied at 101-101.

On Tuesday, Governor Shapiro delivered his much-anticipated budget proposal for the Commonwealth, setting forth his policy and spending priorities for the Commonwealth’s 2024-25 fiscal year. The combined operating budget – inclusive of state, federal and special funds – totals $125.3 billion, an increase of 6.1%. Central components from Gov. Shapiro’s speech and budget proposal include:

• Increasing the state minimum wage from $7.25/hour to $15/hour. Also, increasing minimum wage for tipped workers to $9.00/hour.
• Funding reduction to the Primary Health Care Practitioner program by $2.8 million (34%).
• Significant increases in funding and program changes for K-12 education.
• Broad shift in the distribution model and allocation of higher education funds, including: Using a single funding model for state-related universities (Penn State, Pitt, Lincoln, and Temple), and those receiving state support, and implementing a 5% funding increase for all state-related universities; Merging PA State System of Higher Education (PASSHE) schools with community colleges, with a combined increase in funding of 15% alongside a new formula for distribution of funding moving forward; Capping in-state tuition at these institutions at $1,000 a semester for students whose families make less than the state’s median income.
• Initiatives that build on the governor’s recently announced statewide economic development plan, with new and increased funding for various programs and initiatives.
• Legalization and regulation of Adult Use Cannabis, with imposition of a 20% tax on the wholesale price.
• $4 million to erase medical debt for thousands of Pennsylvanians.
• Implementation of a skills games tax on gross gaming revenue from electronic skill games machines of 42%.

More information on the Department of Human Services budget proposal will be provided in a DHS briefing Friday morning that PACHC will participate in. Shapiro administration leaders will next meet with legislators to respond to questions and make their case on the governor’s budget proposal as the process continues to negotiate a final state budget and associated code bills by the deadline of June 30, 2024.

Professional, non-clinical patient navigation is an evidence-based intervention that improves cancer outcomes from screening through survivorship. The American Cancer Society Leadership in Oncology Navigation (ACS LION) is a standardized training and credentialing program that helps navigators deliver this essential support to individuals, caregivers, and families experiencing cancer. The program meets the training requirements of the Centers for Medicare & Medicaid Services (CMS) for “Principal Illness Navigation” reimbursement and is aligned to professional oncology navigation (PONT) standards.

Enrollment is open.

Last week, the U.S. Department of Health and Human Services (HHS), through the Administration for Strategic Preparedness and Response (ASPR), released voluntary health care specific cybersecurity performance goals (CPGs) and a new gateway website to help Health Care and Public Health (HPH) sector organizations implement these high-impact cybersecurity practices and ease access to the plethora of cybersecurity resources HHS and other federal partners offer. As outlined in the recent HHS Health Care Sector Cybersecurity concept paper, HHS is publishing the CPGs to help healthcare organizations, and healthcare delivery organizations in particular, prioritize implementation of high-impact cybersecurity practices. The HPH CPGs are designed to better protect the healthcare sector from cyberattacks, improve response when events occur, and minimize residual risk.

A new KFF publication discusses Health Professional Shortage Area (HPSA) designations for primary care providers, particularly the challenges with collecting data on policy measures intended to reduce shortages. Where Are the Nation’s Primary Care Providers? It’s Not an Easy Answer also discusses recruitment and retention incentive programs, who qualifies as a primary care provider, and rural-specific concerns.

Clinicians currently serving in the National Health Service Corps can receive additional funds to repay their health professions training loans in exchange for extending their service by one year. HRSA’s Bureau of Health Workforce has announced FY24 continuation award amounts of $20,000 per year for full-time clinicians, and $10,000 per year for those working half-time. If your contract ends between April1 and July 31, 2024, you have until Feb. 27 to apply. If your contract ends between Aug. 1 and Sept. 29, 2024, you have until May 24. Find out more at HRSA Continuation Contracts for National Health Service Corps Loans.