Pennsylvania Medicaid

DeBrunner Consultants Lead NPA Forum Session

DeBrunner & Associates’ Pennsylvania managing director Michael Chirieleison and senior policy analyst Janel Gleeson led a session on “State and PACE Organization Efforts to Raise Awareness About PACE” during the National PACE Association’s 2025 Spring Policy Forum in Washington, D.C. last week. PACE is a joint Medicare/Medicaid program through which older adults meet their health care needs in the community instead of going to a nursing home or other care facility. During the two-day forum, congressional staff and experts on PACE programs shared their perspectives on policies and issues affecting both the PACE model of care and the environment in [...]

joe2025-03-19T12:41:08-04:00March 24, 2025|Pennsylvania, Pennsylvania Medicaid, Pennsylvania Medical Assistance|

Pennsylvania Considers Screening Would-Be Nursing Home Buyers

Even before the federal government announced that it would release data on hospital and nursing home ownership as a means of casting light on the impact of private equity on provider quality and costs, regulators in Pennsylvania were proposing their own approach by seeking to vet those aspiring to purchase nursing homes in their state. Under nursing home regulations proposed by the Pennsylvania Department of Health, regulators would have an opportunity to examine the past performance and financial strength of entities seeking to purchases nursing homes. As more for-profit entities enter the industry, the department notes, they bring with them [...]

iqtsupport2022-04-27T06:00:06-04:00April 27, 2022|Medicaid regulations for long-term care, Pennsylvania Medicaid, post-acute care|

COVID Drives Major Increase in PA Medicaid Enrollment

Medicaid enrollment in Pennsylvania has risen nearly 14 percent in the past year as rising unemployment resulting from COVID-19 drives people to turn to the state for health insurance. As a result, Pennsylvania has added nearly 400,000 people to its Medicaid rolls in the past year. Today, 3.2 million Pennsylvanians are enrolled in the state’s program, although among them are approximately 250,000 who would have been dropped from the program except for a federal requirement that the state not drop people from the program in exchange for a major increase in federal aid for the state’s program. As a result [...]

iqtsupport2021-03-24T06:00:12-04:00March 24, 2021|Pennsylvania Medicaid|

Pennsylvania to Introduce Medicaid PDL on January 1

Starting on January 1, Pennsylvania will employ a preferred drug list for its Medicaid program – a list that applies to both fee-for-service and managed care patients. And as many as 150,000 of the state’s 2.8 million Medicaid beneficiaries may find themselves facing changes in their prescription drugs. The purpose of the PDL is to save money – an estimated $85 million a year, according to the Pennsylvania Department of Human Services, which administers the state's Medicaid program. While physicians may submit requests to the state for exemptions for specific patients for specific purposes, those exemptions may be relatively uncommon: [...]

iqtsupport2019-12-26T11:42:42-05:00December 26, 2019|Medicaid, Pennsylvania, Pennsylvania Medicaid, Pennsylvania Medical Assistance|

PA Delays New Long-Term Care Program

The Pennsylvania Department of Human Services will delay for six months the introduction of its Community HealthChoices program in southeastern Pennsylvania. The program’s implementation in the five-county Philadelphia area, scheduled to begin on July 1, 2018, has been pushed back to January 1, 2019. Preparations are currently under way to launch Community HealthChoices in 14 southwestern Pennsylvania counties on January 1, 2018. Community HealthChoices is a new state program of managed long-term services and supports for Pennsylvanians over the age of 55 who are eligible for both Medicare and Medicaid. Learn more about the program’s delay in southeastern Pennsylvania in [...]

iqtsupport2017-11-09T06:00:33-05:00November 9, 2017|Pennsylvania Medicaid|

PA Governor Vetoes Medicaid Work Requirement

Pennsylvania Governor Tom Wolf has vetoed a bill that included a requirement that certain Medicaid recipients either work or search for work. Learn more about the governor’s veto, and his reason for doing so, in this Associated Press news report.

iqtsupport2017-10-24T06:00:15-04:00October 24, 2017|Pennsylvania Medicaid|