Provider recommendation for the Human papillomavirus (HPV) vaccine is considered the most effective determinant of vaccine uptake compared to other interventions such as parent education. PA Cancer Coalition has partnered with stakeholders in neighboring states, MD, WV, OH, VA, DC and DE in a multi-state Call to Action to increase HPV vaccination by strong and consistent provider recommendations and initiation of HPV vaccination starting at age nine. HPV vaccination is cancer prevention! March 4 is International HPV Awareness Day; participate in this Call to Action.

The National Council for Mental Wellbeing is pleased to offer a new virtual opportunity for training in Screening, Brief Intervention, and Referral to Treatment (SBIRT). If you are an administrator or clinician who is new to SBIRT or looking for a refresher course, this three-hour training on March 6 at 2:00 pm is just for you. Participants will learn how SBIRT fits into the context of health and providing whole-person, integrated and trauma-informed systems of care. Attendees will also learn the use of evidence-based screening tools for adolescents and adults to identify risk levels of alcohol and drug use, the role of brief interventions when looking to increase patient engagement, and referral, and treatment best practices for managing and supporting people with substance use disorders.

The first report card on the state of the nation’s primary health care was released last week, and it’s nothing to brag about. The report comes in response to a 2021 report by the National Academies of Sciences, Engineering, and Medicine, which called for a scorecard to be developed to monitor — and improve — America’s primary care. Funded by the Milbank Memorial Fund and the Physicians Foundation, two nonprofits working on improving health care, it’s designed to offer baseline data for the federal government and state governments in the financing, access, workforce development, and research. Read more.

The National Association of Community Health Center (NACHC) has released a report finding that more than 100 million Americans face barriers to accessing primary care. A trend of rural hospital closures and a worsening shortage of primary care providers are driving the crisis, leaving one-third of the U.S. population vulnerable to public health threats and untreated chronic diseases. The report describes America’s medically disenfranchised population and how, with expanded federal resources, Community Health Centers can begin to address gaps in primary care. U.S. Today covers the report.

The Biden administration has issued a $30 million Funding Opportunity Announcement (FOA) to enhance early childhood development services and improve outcomes for children served by Community Health Centers. The goal of the funding is to increase the number of infants and young children served by health centers who receive age-appropriate developmental screenings and prompt follow-up services for conditions that could affect their development. A new brief from the Geiger Gibson/RCHN Community Health Foundation Research Collaborative outlines the objectives of the FOA, documents the essential role of Community Health Centers in caring for young children in vulnerable communities and at risk for developmental delay, and explores the opportunities to effectively support child health and development in health centers.

While Pennsylvania initially intended to end its years-long practice of paying parents of children with complex healthcare needs who provide home health aide care to their own children, that decision has changed. When it was discovered that Pennsylvania planned to end the program, advocates, families, and other stakeholders urged the state to continue the program considering the continued and increasing direct care worker shortage. In response, the Pennsylvania Department of Human Services (DHS) sought and received federal approval to continue the program after the public health emergency ends. DHS will be sending notices to families letting them know the program will continue as well as providing additional details on how the program will operate.

The Drug Enforcement Administration (DEA) announced last week that it is proposing rules to make permanent many flexibilities for telemedicine that were established amid the COVID-19 pandemic, with certain safeguards. The DEA said in a release that the rule will give patients access to virtual therapies beyond the end of the COVID-19 public health emergency, which is scheduled to conclude in May. The rules would include certain safeguards for telemedicine consultations from a medical provider who has not conducted an in-person evaluation of a patient and that results in the provider prescribing the patient a controlled medicine. They would allow medical providers to prescribe a 30-day supply of Schedule III and Schedule IV non-narcotic controlled drugs, which are the least likely to result in drug abuse, or a 30-day supply of buprenorphine to treat opioid use disorder without an in-person evaluation or referral, according to the release. The DEA added that the rules would not affect telemedicine consultations that do not involve prescribing controlled medications or those where the provider has conducted an in-person examination of the patient. The updates would also not affect telemedicine consultations and prescriptions from a provider that a patient has been referred to if the referring provider has conducted an in-person examination.

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.