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DPW Halts PH 95 Copayment Initiative
October 5, 2012

PCPA was notified that the Department of Public Welfare (DPW) would announce October 5 that the department would delay the implementation of co-payments for the 48,000 “loophole” families that would have been impacted by the recently announced process. The announcement from DPW states that “implementation of co-payments is being delayed until further notice while we pursue the review of a premium as an alternative to co-pays to accomplish the shared goal of implementing a cost-sharing program like many other states already have implemented. In the meantime, families will not owe a copayment for any services until further notice.”

The delay will allow the department to work with stakeholders, including PCPA, toward a shared goal of finding the best cost-sharing proposal for Pennsylvania and then to subsequently seek approval from the Centers for Medicare and Medicaid Services. A spokesperson for DPW noted that the “department has long viewed a fair premium as a better approach to cost-sharing and upon hearing feedback over the last few weeks from families, stakeholders, legislators and other interested parties to the department’s proposal, we believe the option of a premium instead of a co-pay should be explored further.”

PCPA has been pleased to have worked with family and provider advocacy organizations, community providers, and families in focusing attention on the complex problems and hardships a co-payment approach would have caused. The association is especially grateful to Rep. Gene DiGirolamo and the House Human Services Committee for efforts around this challenging issue.

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