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PH 95 Co-payment Update
October 5, 2012

On October 3 the Pennsylvania House of Representatives adjourned unexpectedly before the Human Services Committee resolution (HR 879) could be introduced for a vote. HR 879 calls for a delay in implementation of the co-payments and that a formal study and report on the initiative be conducted. HR 879 also notes reasons for postponing co-payment implementation, including:

  • The Department of Public Welfare’s (DPW) methodology for collecting a fair share of the costs of care for the children;
  • The process for calculating the ongoing amount of co-payments for each family in real time, ensuring this burden is not placed on families;
  • DPW bulletin stating that they are in no position to comply with this requirement; and
  • The opinion of the House of Representatives that the potential savings are not worth the ensuing chaos if the proposal is implemented without regard for the many questions that have arisen about it.

PCPA, families, and consumer advocacy organizations have contacted members of the legislature and the governor’s office to communicate their confusion and concern about the significant impact of the co-payment on many families and the manner in which the co-payment process will be conducted by the HealthChoices physical and behavioral health managed care organizations.

At the October 4 Medical Assistance Advisory Committee’s Managed Care Delivery System Subcommittee meeting, updates were provided by the department on the status of physical health managed care organizations (PH-MCO), behavioral health managed care organizations, and counties relative to the co-payment. While no managed care company has submitted a formal plan to DPW for co-payment implementation, half of the PH-MCOs have informally indicated that they will not pass on the copayment to providers and consumers at this time. The Office of Mental Health and Substance Abuse Services indicated that nearly all the counties will be requiring providers to charge and collect co-payments. Before a managed care organization can implement any co-payment process they must submit a plan to DPW for approval and provide 30 days notice to families prior to implementing that plan.

Due the large response to the Health Law Project co-payment webinar at 12:00 p.m. October 5, organizers had to change the conference phone number. The new number is 866-906-9330 and the password is 3064175. If members or families need to register, access http://ow.ly/ecsnS.

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