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Advocacy

HAP Comment Letter to DHS on Notice of Transition to Traditional Medicaid Expansion

April 24, 2015

Regulations Coordinator
Department of Human Services
Office of Medical Assistance Programs
Room 515, Health and Welfare Building
Harrisburg, PA 17120

RE: Notice of Transition to Traditional Medicaid Expansion, 45 Pa.B. 1576, Saturday, March 28, 2015

Dear Regulations Coordinator:

On behalf of The Hospital & Healthsystem Association of Pennsylvania (HAP), which represents approximately 240 member institutions, including 125 stand-alone hospitals and another 120 hospitals that comprise 32 health systems across the state, we appreciate the opportunity to provide comments about the notice published in the Pennsylvania Bulletin on March 28, 2015, by the Department of Human Services (DHS), identifying its intent to transition to a traditional Medicaid expansion, as provided for under the Patient Protection and Affordable Care Act (ACA) (Pub. L. No. 111–148).

A key component of this transition is the creation of a single Medicaid adult benefit plan that will include the traditional adult Medicaid population, as well as newly eligible adults under Medicaid expansion.

DHS will consolidate 14 pre-existing Medicaid benefit plans and the three adult benefit plans established under Healthy Pennsylvania into one Medicaid adult benefit plan, which will provide coverage for all eligible adults.

HAP strongly supports Medicaid expansion and the transition to the single Medicaid adult benefit plan.

The implementation of the single benefits package for all eligible adults will streamline, simplify, and improve coverage—benefiting both the enrollee and the providers serving their health care needs.

HAP also supports the removal of existing treatment limits, which will help assure adequate benefits are available to individuals when needed. This includes the removal of:

  • Inpatient rehabilitation hospital limit of one admission per year
  • Inpatient psychiatric hospital limit of 30 days per year
  • Six prescription drug limit per month
  • Outpatient psychiatric and drug and alcohol treatment limits

HAP supports the elimination of the health screening requirement, and the different benefits packages will improve access and coverage for individuals. Eliminating this requirement also should simplify the administration and delivery of services for providers.

HAP commends DHS for its communication with consumers, health plans, and the provider community regarding the transition to Medicaid expansion.

We look forward to continued efforts to provide outreach to eligible individuals and to assure that low-income Pennsylvanians secure access to health coverage.

HAP appreciates the opportunity to provide comments about this notice. If you have any questions about HAP’s comments, please feel free to contact Robert Greenwood vice president for health care finance and insurance at (717) 561-5358, or me at (717) 561-5344.

Sincerely,

Paula A. Bussard
Chief Strategy Officer

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