On October 15, 2019,the Pennsylvaia Department of Human Services (DHS) released the Pennsylvania HealthChoices Physical Health Medicaid Managed Care request for applications (RFA). Reflecting the current framework, Medicaid managed care organizations (MCOs) will serve the five HealthChoices zones covering all 67 counties: Southeast, Southwest, LehighCapital, Northwest, and Northeast. Contracts are worth nearly $13 billion. Pennsylvania failed to implement new contracts and negated awards from 2016 as well as the awards from the 2017 rebid. As a result, the HealthChoices program is currently operating under extensions of contracts originally awarded in 2012. The most recent awards in early 2017, which would have been for a three-year, $12 billion contract, were protested by Aetna, UnitedHealthcare, and AmeriHealth Caritas, leading the state to cancel the RFA and reissue the procurement. Applications are due December 17, 2019, and contracts are expected to begin January 2021, running for five years, with an option to extend for an additional period of three years. An award date was not announced.

Pennsylvania Insurance Commissioner Jessica Altman announced Pennsylvania’s approved 2020 individual and small group ACA health insurance rates, highlighted increased marketplace competition within several counties and noted a decrease in counties with only one carrier. Click here to see the press release. Pennsylvania will have seven insurers in the health insurance market offering individual plans for 2020.

• Ambetter
• Capital Blue Cross
• Geisinger Health Plan
• Highmark
• Independence Blue Cross
• Oscar
• UPMC

On October 11, 2019, two District Courts issued nationwide preliminary injunctions to stop the Trump Administration’s public charge rule, which would have taken effect Oct. 15, 2019.  This proposal was opposed by NACHC, PACHC and many other organizations that expressed concern about the proposal’s impact on immigrant families and refugees. An article further explaining the ruling can be found here. A Kaiser Family Foundation study showed Community Health Centers   reported that immigrant patients have declined to enroll in or renew Medicaid coverage out of fear of becoming a public charge, even those patients who are not covered by this rule.

The Pennsylvania Department of State this announced a brand new public facing Licensure Processing Guide. The guide breaks down the licensing process into three phases and provides the average length of time each phase will take as of the previous quarter. It also offers recommendations for how to shorten processing times. Additionally, new to the department’s website are two short videos, “How to Apply for a Professional License” and “What Happens to My Application.” The first boards featured in the Licensure Processing Guide are the Cosmetology, Nursing and Osteopathic Medicine Boards. More licensing boards will be built and additional licenses will be added to existing boards on a rolling basis, with the Medical, Real Estate and Engineering Boards in process now.

The Drug Enforcement Administration has announced that it will collect unwanted vaping devices during its National Prescription Drug Take Back Day, which is scheduled to take place from 10 a.m. to 2 p.m. tomorrow at collections sites throughout the United States. The announcement comes as updated CDC data shows the number of cases of a lung illness officials believe is linked to e-cigarette use and vaping has reached 1,604. (Sources: NPR’s “Shots,” 10/25; CNN, 10/24)

Cleveland Clinic this week released its annual list of the top 10 medical innovations the health system predicts will “transform health care” in 2020. The list includes a dual-acting osteoporosis drug, an oral immunotherapy to reduce the effect of peanut allergies, and more. (Source: Becker’s Health IT & CIO Report, 10/24)

Governor Tom Wolf this month announced that Pennsylvania has been awarded a $1.3 million grant to increase access to the National Suicide Prevention Lifeline by expanding state-based call centers.

Continue reading “Pennsylvania is Expanding In-State Lifeline Call Centers” →

The Republican Study Committee (RSC), which is comprised of conservative House lawmakers, this week released a framework to reform the U.S. health care system by eliminating parts of the Affordable Care Act and providing states with more regulatory authority. RSC members have said the proposal is designed to be an alternative to so-called “Medicare-for-All” and other single-payer proposals being touted by Democrats. (Source: The Hill, 10/22)

This annual report from the Center for Connected Health Policy (CCHP) is the most current guide of Medicaid provider manuals, state laws, and regulations for telehealth in all 50 states and the District of Columbia.  Key findings this year include reimbursement for some form of live video in all states and DC, and 22 states with reimbursement for remote patient monitoring.  The report includes an interactive map of policies as well as an at-a-glance infographic.  Click here to access the guide.

Data that a think-tank published this week shows where the challenges are greatest, along with some of the underlying factors that can make it difficult for people to afford food. Read full article »