Pennsylvania Medical Assistance

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 [...]

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: [...]