On February 21 the PA Senate Appropriations Committee opened up its series of hearings on Governor Corbett’s proposed 2012-13 Budget with an exchange with the Governor’s Budget Office. The Committee discussed the accuracy of revenue projections for the end of the fiscal year and the Administration’s revenue growth projections for the upcoming fiscal year. The panel also discussed the use of money from “dedicated funds” to supplement the General Fund and investigation and prosecution of welfare fraud. In its session with the Department of Health the Senate Appropriations Committee members questioned Health Department deputies on several issues, including the independence of the PA Health Care Cost Containment Council (PHC4) and the Patient Safety Authority under the proposed budget and the need to upgrade hospital licensing and inspections. DOH told lawmakers that anticipated efficiencies and fiscal concerns prompted the proposal for consolidation of PHC4 and the Patient Safety Authority with DOH. DOH also said that in reducing its funding for health research about $59 million from the Commonwealth Universal Research Enhancement (CURE) program was used in PA Department of Public Welfare for long-term care services instead of research. The panel also discussed status of the State Health Improvement Plan and statistics for health care associated infections following passage of Act 52. The Senate Appropriations Committee also heard this week from the Department of Insurance and discussed Pennsylvania’s compliance with the federal Patient Protection and Affordable Care Act (PPACA); development of the health exchange in compliance with PPACA; essential coverage under PPACA; the status of the MCARE fund; the dispute between Highmark and UPMC and Highmark’s acquisition of Allegheny General Hospital; and increasing auto insurance minimum coverage requirements. In its hearing with the Department of Labor and Industry members of the Senate Appropriations Committee questioned L&I Secretary Julia Hearthway regarding unemployment compensation; funding for the new Keystone Works job training program; elimination of the PENNSAFE program, proposed regulations to prevent mandatory overtime for health care providers, the Pennsylvania Initiative on Assistive Technology, the State Workers’ Insurance Fund., and fees for administrative costs for Centers for Assisted Living. FMI: Each of the completed Senate hearings can be accessed at http://www.pasenategop.com/budget-hearings/2012/summary.htm
On February 21 the PA House of Representatives opened its hearings and focused on the larger budget questions in discussion and review with the Independent Fiscal Office and the Department of Revenue. At the House Appropriations Committee, the Independent Fiscal Office reaffirmed that it is still projecting a revenue shortfall about $200 million less than the Corbett administration’s $719 million projection. On February 21 the PA Department of Revenue reviewed their budgets before both the House and Senate Appropriations committees. PA Department of Revenue pledged to report to the legislature on any revenue estimate changes as they occur and as the final passage of the budget approaches. FMI: Completed House hearings can be accessed at http://www.pahousegop.com/budgethrgsked.aspx.
On February 24 the PA Department of Public Welfare (DPW) posted on its website the regulations and preambles related to notices issued in the Pennsylvania Bulletin on expedited rulemaking under Act 22 of 2011. PARF members are encouraged to review the regulations and send comment to PARF at parfmail@parf.org. For a copy of the regulations that are posted see http://www.dpw.state.pa.us/publications/budgetinformation/act22-expeditedregulatorychangestothedpw/index.htm. DPW explains that as part of Act 22 in the 2011/2012 state budget, the General Assembly granted DPW the ability to make changes to its regulations without going through the formal review process. For each draft regulation, DPW provides an email address and a postal mailing address to which comments may be sent. For email comments, the chapter of the draft regulation must be provided in the subject line. DPW says that comments should clearly define which section of the draft regulation. All comments must be received by 4:00 p.m. on Friday, March 9. PARF members should forward comments to DPW and forward a copy of the comments to PARF at parfmail@parf.org.
On February 23 the Medical Assistance Advisory Committee (MAAC) of the PA Department of Public Welfare (DPW) was presented with a review of regulatory changes that were announced in the February 18, 2012 edition of the Pennsylvania Bulletin. The deadline for comments to the February 18 public notice is March 4, 2012. Dan Delellis, OMAP, Bureau of Policy, Budget and Planning, presented the recently announced expedited rule making issuances for the Office of Medical Assistance (OMAP). In his review he noted: (1) Copayments: MA co-pays are being adjusted using the CPI inflation adjustment and the regulations will allow for future updates also based on the CPI. In addition, the MATP Para-transit services will now have co-pays of $2.00 (one-way) and $4.00 (round trip). The regulation also eliminates currently allowed refunds of co-pays over a certain threshold per annum. (2) Reduced pharmacy dispensing fees: Pharmacy dispensing fees will be reduced and adjustments are being made to equalize the average wholesale acquisition costs. (3) Newborn Payments: Separate payment to hospitals for a normal newborn will be eliminated. MA will now only pay for the mother’s birthing expenses. (4) Hospital Readmission: The regulations will also be revised for the hospital readmission policy change (14 days to 30 days) already implemented as a result of Act 22. Kevin Friel, DPW Deputy Secretary of Developmental Programs (ODP) Kevin Friel gave the overview of the ODP expedited regulations. Friel noted (5) ODP Payments: 55 Pa Code Chapter 51 will establish payment rates, fee schedules and payment methods for home and community bases services and provider qualifications for Adult Autism and the Coordinated and Person/Family Directed Support waiver and (6) ICF MR: the Private ICF-MR regulations (55 Pa Code Chapter 6211) will be updated for payment method and cost report changes. Bonnie Rose, Deputy Secretary for OLTL, and Elaine Smith addressed the OLTL expedited regulation package (55 Pa Code Chapter 52), noting that (7) OLTL Bulletins: The package will establish provisions in regulation for policies that were previously issued through MA Bulletins. The new chapter will apply to the Aging, Attendant Care, COMMCARE, Independence and OBRA Home and Community Based Service waivers and the Act 150 program. FMI: See http://www.dpw.state.pa.us/publications/budgetinformation/act22-expeditedregulatorychangestothedpw/index.htm
On February 23 the Medical Assistance Advisory Committee (MAAC) of the PA Department of Public Welfare (DPW) was presented with a review by the DPW Office of Medical Assistance Programs (OMAP) of Governor Corbett’s proposed FY 2012-13 budget for Medical Assistance programs. PA DPW Deputy Secretary of Medical Assistance Programs Vince Gordon reported on various program expansions, including the expansion of the HealthChoices Program to the remainder of the state which will add 400,000 MA recipients to the program and the expansion of the pre- and post-payment automated audit system which will use predictive modeling and will go beyond the Claims Check system currently in use. Deputy Secretary Gordon said that there will be additional initiatives required by Federal health care reform, including program integrity expansions. With regard to payment reductions, he said that payment rates will be reduced by 4.0% with no reduction to disproportionate share hospital (DSH) and supplemental payments. Gordon noted that OMAP will expand its high cost case review (case management) which will also consider cases in other program areas such as Long Term Living and Developmental Programs. Concerning program changes Deputy Secretary Gordon noted that reforms in General Assistance consisted of revisions to eligibility criteria. Gordon said that the proposed hospital application process will target newly enrolled MA recipients that become eligible through a hospitalization and that these recipients will remain in the Fee-for-Service Program (FFSP) until they are due for re-determination in six months. The reforms in the Medical Assistance for Workers with Disabilities (MAWD) program will consist of applying an increase to enrollee premiums. Deputy Secretary Gordon also noted that an $8.0M increase to the Medical Assistance Transportation (MATP) Program’s budget has been proposed and that amount is half of the FY 2012 MATP Program’s cut. Gordon said that while initiating co-pays will help, there are still structural program deficiencies. FMI: See www.dpw.state.pa.us
On February 23 the Medical Assistance Advisory Committee (MAAC) of the PA Department of Public Welfare (DPW) was presented with a report on the FY 2012-13 budget proposed by Governor Corbett for the Office of Developmental Programs. Kevin Friel, DPW Deputy Secretary of Developmental Programs (ODP) and ODP fiscal director John Cox discussed the proposed budget for ODP. DPW Deputy Secretary Friel noted that there is a 2.0% increase in the Community Waiver Program. He said that the community base programs were reduced 20% and the entire line item was moved into the Human Services Development Fund. Deputy Secretary Friel said that state Centers received a 3.0% increase that was mostly attributable to higher personnel and other administrative cost increases. He noted that the Autism budget was decreased by 6.0%. In an addition to his report on the budget, Deputy Secretary Friel said that ODP is targeting mid-March for its roll out of changes to the fee schedule. FMI: See www.dpw.state.pa.us.
