Health Law News
January 31, 2020
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New Format, but Same Content
Our newsletter has a new look! We hope this format will make it easier for you to access and share our articles. We welcome your feedback about the format and future topics; please email your suggestions to event@phlp.org.
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Community HealthChoices Updates
Community HealthChoices (CHC), Pennsylvania’s managed care long-term services & supports program, completed its three-year, three-phase roll out on January 1, 2020 when the program began in the Northwest, Northeast, and Lehigh/Capital regions (Phase Three). Approximately 145,000 Pennsylvanians were impacted by this change, including over 67,500 in the Lehigh-Capital Zone, 49,700 in the Northeast, and 27,900 in the Northwest.
Read more on our website.
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Governor Wolf Launches Reach Out PA: Your Mental Health Matters
On January 2nd, Governor Wolf announced “Reach Out PA”: a multi-agency effort and anti-stigma campaign focused on expanding resources and the state’s overall support of mental health care and services. Governor Wolf stated, “for those struggling with their mental health we have one message: your mental health matters and it’s okay to reach out for help.” Reach Out PA will include many initiatives, some of which were already announced.
Read more on our website.
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Reminder about Medicare Enrollment Periods
Now that we are in a new plan year for people with Medicare health coverage, some Medicare beneficiaries may find that that their current coverage does not meet their needs. This article reminds readers about available enrollment periods that allow people to change their plans during the year.
Read more on our website.
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2020 Federal Poverty Level Guidelines Published
The 2020 Federal Poverty Levels (FPLs) have been announced and are effective January 15, 2020. The new figures are somewhat higher than last year’s guidelines. The poverty guidelines are used to set income limits for public health programs such as Medicaid, CHIP, Medicare Part D Extra Help and Marketplace Premium Tax Credits.
Read more on our website.
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Smooth Transition to Uniform PDL Reported
According to state officials, Pennsylvania’s Medicaid program transitioned to a single statewide Preferred Drug List (PDL) on January 1, 2020, without any major problems. According to the DHS pharmacy director, some pharmacies reported availability problems for one generic form of Concerta (a stimulant), but other generics are also preferred and widely available. As we reported in October (here), the change away from the Medicaid managed care plans all using separate formularies to a uniform PDL was expected to impact almost 150,000 Medicaid consumers.
Read more on our website.
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Electronic Visit Verification (EVV) Update
In our November/ December Newsletter, we advised readers that the Pennsylvania Department of Human Services (DHS) requested a Good Faith Effort Exemption from the federal Centers for Medicare and Medicaid Services (CMS) to delay final implementation of Electronic Visit Verification (EVV). Readers may remember that the use of EVV is required by the 21st Century Cures Act for home health aide services paid by Medicaid. DHS implemented a “soft launch” of EVV in October 2019 to help providers, employers, and managed care plans get familiar with the system and work out any problems prior to the January 1, 2020 implementation required by the law.
Read more on our website.
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Medical Assistance Transportation Program (MATP) Update
Medicaid covers rides for eligible individuals to and from the doctor’s office, the hospital, or another medical office for Medicaid-approved care. This coverage is called “non-emergency medical transportation” or NEMT, because it does not involve a medical emergency. Medicaid consumers who need a ride to a medical appointment, and it is not an emergency, require prior approval.
Read more on our website.
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Bureau of Autism Services Name Change
The Office of Developmental Programs (ODP) announced on 10/30/2019 that the Bureau of Autism Services (BAS) will change its name the Bureau of Supports for Autism and Special Populations (BSASP). In addition to their support of Pennsylvanians with Autism Spectrum disorder, the program has expanded and will now include a Special Populations Unit which will focus on support of individuals who are Deaf, Hard of Hearing, and Deaf-Blind.
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