Govt. Affairs

Message from Richard Edley, RCPA President & CEO:

On January 19, 2017, RCPA sent out an announcement urging individuals to contact the governor’s office regarding the concerns over the proposed ODP Medicaid waiver amendments, specifically related to Chapter 2390 licensed vocational facilities and Chapter 2380 licensed adult training facilities. I am pleased to say that this is NOT a necessary step at this time.

I have spoken directly with Nancy Thaler, Deputy Secretary of the Office of Developmental Programs (ODP), and she has notified me that ODP will hold a meeting of all day/vocational providers in early March to review questions, concerns, and the entire process. This is similar to the recent meeting ODP had with all residential providers.

This is in addition to the upcoming three day (01/31 – 02/02) work group of stakeholders being held by ODP to review the proposed regulations and the comments received. I will be representing RCPA and we will have several provider and other member representatives also in attendance.

In light of these meetings and the proposed process, it would be more appropriate to enter in that discussion and suspend direct calls to the governor’s office. While we have concerns, ODP has assured us that there will be a forum and mechanism to voice these concerns and to have a more constructive discussion.

If you have any questions, please contact me. RCPA will certainly provide an update after the conclusion of these meetings.

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Save the Date Tuesday, January 17:
Call Congress to Protect Medicaid Expansion

As Congress continues taking steps to repeal the Affordable Care Act, the National Council for Behavioral Health is joining together with Mental Health America, Addiction Policy Forum, Depression and Bipolar Support Alliance, and National Alliance on Mental Illness to protect the ACA’s Medicaid expansion.

Next Tuesday, January 17, we are asking advocates to join us in a nationwide call-in day to protect patients’ access to mental health and addictions services by preserving the Medicaid expansion. By taking just 10 minutes next Tuesday to call your Representative and two Senators, you will join thousands of dedicated advocates to have your voice heard in Congress. Join us and help save Medicaid expansion in 2017!

Why is Medicaid expansion important? Medicaid expansion is vital to our community—it provides health coverage to millions of Americans with mental health and addiction disorders. Without Medicaid expansion, low-income people across the country will be left as they were before the ACA, with no pathway to affordable health coverage.

Why advocate now? It is urgent that we defend Medicaid expansion now before Congress votes on ACA repeal. The more noise we make now, the better our chances of delaying or stopping future cuts to Medicaid.

Call-In Day Prep: Mark your calendar for January 17! The National Council will send out more information including step-by-step instructions for National Call-In Day to Protect Medicaid Expansion next week. In the meantime, you can prepare for your calls by reviewing these Call-In Day Instructions and Medicaid expansion talking points.

Have questions? Please feel free to reach out to Stephanie Pellitt at StephanieP@thenationalcouncil.org.

Thank you for your continued hard work and advocacy as we work to protect Medicaid in 2017.

Sincerely,

Chuck Ingoglia
Senior Vice President, Public Policy and Practice Improvement
National Council for Behavioral Health

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The Pennsylvania Senate announced the appointment of both Republican and Democratic committee chairs for the 2017–18 legislative session.

The appointments are as follows:

Aging & Youth:
Michele Brooks (R–Mercer)
Art Haywood (D–Montgomery)

Agriculture & Rural Affairs:
Elder Vogel (R–Beaver)
Judy Schwank (D–Berks)

Appropriations:
Pat Browne (R–Lehigh)
Vincent Hughes (D–Philadelphia)

Banking & Insurance:
Donald White (R–Indiana)
Sharif Street (D–Philadelphia)

Communications & Technology:
Ryan Aument (R–Lancaster)
Art Haywood (D–Montgomery)

Community, Economic & Recreational Development:
Mario Scavello (R–Monroe)
Larry Farnese (D–Philadelphia)

Consumer Protection & Professional Licensure:
Robert Tomlinson (R–Bucks)
Lisa Boscola (D–Northampton)

Education:
John Eichelberger (R–Blair)
Andrew Dinniman (D–Chester)

Environmental Resources & Energy:
Gene Yaw (R–Lycoming)
John Yudichak (D–Luzerne)

Finance:
Scott Hutchinson (R–Venango)
John Blake (D–Lackawanna)

Game & Fisheries:
Pat Stefano (R–Fayette)
Jim Brewster (D–Allegheny)

Intergovernmental Operations:
Camera Bartolotta (R–Washington)
Anthony Williams (D–Philadelphia)

Judiciary:
Stewart Greenleaf (R–Montgomery)
Daylin Leach (D–Montgomery)

Labor & Industry:
Kim Ward (R–Westmoreland)
Tina Tartaglione (D–Philadelphia)

Law & Justice:
Charles McIlhinney (R–Bucks)
Jim Brewster (D–Allegheny)

Local Government:
Scott Wagner (R–York)
John Blake (D–Lackawanna)

Public Health & Welfare:
Lisa Baker (R–Luzerne)
Judy Schwank (D–Berks)

Rules & Executive Nominations:
Jake Corman (R–Centre)
Jay Costa (D–Allegheny)

State Government:
Mike Folmer (R–Lebanon)
Anthony Williams (D–Philadelphia)

Transportation:
John Rafferty (R–Montgomery)
John Sabatina (D–Philadelphia)

Urban Affairs & Housing:
Tom McGarrigle (R–Delaware)
Wayne Fontana (D–Allegheny)

Veterans Affairs & Emergency Preparedness:
Randy Vulakovich (R–Allegheny)
Jay Costa (D–Allegheny)

The House of Representatives announced the appointments of both Republican and Democratic committee chairs for the 2017–18 legislative session.

The following appointments are unofficial until announced on the House floor:

Aging and Older Adult Services:
Republican: Rep. Tim Hennessey, 26th Legislative District, Chester and Montgomery counties.
Democrat: Rep. Steve Samuelson, 135th Legislative District, Northampton County.

Agriculture and Rural Affairs:
Republican: Rep. Martin Causer, 67th Legislative District, Cameron, Potter, and McKean counties.
Democrat: Rep. Eddie Day Pashinski, 121st Legislative District, Luzerne County.

Children and Youth:
Republican: Rep. Kathy Watson, 144th Legislative District, Bucks County.
Democrat: Rep. Scott Conklin, 77th Legislative District, Centre County.

Commerce:
Republican: Rep. Brian Ellis, 11th Legislative District, Butler County.
Democrat: Rep. W. Curtis Thomas, 181st Legislative District, Philadelphia County.

Consumer Affairs:
Republican: Rep. Robert Godshall, 53rd Legislative District, Montgomery County.
Democrat: Rep. Thomas R. Caltagirone, 127th Legislative District, Berks County.

Education:
Republican: Rep. Dave Hickernell, 98th Legislative District, Lancaster and Dauphin counties.
Democrat: Rep. James Roebuck, 188th Legislative District, Philadelphia County.

Environmental Resources and Energy:
Republican: Rep. John Maher, 40th Legislative District, Allegheny and Washington counties.
Democrat: Rep. Mike Carroll, 118th Legislative District, Luzerne and Lackawanna counties.

Finance:
Republican: Rep. Bernie O’Neill, 29th Legislative District, Bucks County.
Democrat: Rep. Jake Wheatley, 19th Legislative District, Allegheny County.

Game and Fisheries:
Republican: Rep. Keith Gillespie, 47th Legislative District, York County.
Democrat: Rep. Bryan Barbin, 71st Legislative District, Cambria and Somerset counties.

Gaming Oversight:
Republican: Rep. Scott Petri, 178th Legislative District, Bucks County.
Democrat: Rep. Patrick Harkins, 1st Legislative District, Erie County.

Health:
Republican: Rep. Matt Baker, 68th Legislative District, Bradford, Potter, and Tioga counties.
Democrat: Rep. Florindo (Flo) Fabrizio, 2nd Legislative District, Erie County.

Human Services:
Republican: Rep. Gene DiGirolamo, 18th Legislative District, Bucks County.
Democrat: Rep. Angel Cruz, 180th Legislative District, Philadelphia County.

Insurance:
Republican: Rep. Tina Pickett, 110th Legislative District, Bradford, Sullivan, and Susquehanna counties.
Democrat: Rep. Tony DeLuca, 32nd Legislative District, Allegheny County.

Judiciary:
Republican: Rep. Ron Marsico, 105th Legislative District, Dauphin County.
Democrat: Rep. Joseph A. Petrarca, 55th Legislative District, Armstrong, Indiana, and Westmoreland counties.

Labor and Industry:
Republican: Rep. Rob Kauffman, 89th Legislative District, Franklin County.
Democrat: Rep. John Galloway, 140th Legislative District, Bucks County.

Liquor Control:
Republican: Rep. Adam Harris, 82nd Legislative District, Franklin, Juniata, and Mifflin counties.
Democrat: Rep. Paul Costa, 34th Legislative District, Allegheny County.

Local Government:
Republican: Rep. Kate Harper, 61st Legislative District, Montgomery County.
Democrat: Rep. Bob Freeman, 136th Legislative District, Northampton County.

Professional Licensure:
Republican: Rep. Mark Mustio, 44th Legislative District, Allegheny County.
Democrat: Rep. Harry Readshaw, 36th Legislative District, Allegheny County.

State Government:
Republican: Rep. Daryl Metcalfe, 12th Legislative District, Butler County.
Democrat: Rep. Greg Vitali, 166th Legislative District, Delaware and Montgomery counties.

Tourism and Recreational Development:
Republican: Rep. David Millard, 109th Legislative District, Columbia County.
Democrat: Rep. Mark Longietti, 7th Legislative District, Mercer County.

Transportation:
Republican: Rep. John Taylor, 177th Legislative District, Philadelphia County.
Democrat: Rep. William F. Keller, 184th Legislative District, Philadelphia.

Urban Affairs:
Republican: Rep. Mark Keller, 86th Legislative District, Cumberland and Perry counties.
Democrat: Rep. Michael O’Brien, 175th Legislative District, Philadelphia County.

Veterans Affairs and Emergency Preparedness:
Republican: Rep. Stephen E. Barrar, 160th Legislative District, Chester and Delaware counties.
Democrat: Rep. Christopher Sainato, 9th Legislative District, Lawrence County.

From: “HS, Secretary’s Office”
Date: January 5, 2017 at 1:01:56 PM EST
To: “DHS-STAKEHOLDERS@LISTSERV.DPW.STATE.PA.US”
Subject: [DHS-STAKEHOLDERS] DHS Awards Medicaid Agreements

Department of Human Services (DHS) Secretary Ted Dallas announced that DHS has agreed to move forward and negotiate agreements with six managed care organizations (MCOs) to deliver physical health services to Pennsylvanians through HealthChoices, Pennsylvania’s mandatory Medicaid managed care program since 1997.

“These agreements will be the most significant changes to Pennsylvania’s Medicaid program since we moved to managed care two decades ago,” said Dallas. “Over the next three years, MCOs will be investing billions of dollars in innovative approaches that reward high-quality care that improves patient health rather than just providing services for a fee.”

The $12 billion, three-year contracts include a 30 percent target for payments based on value received or outcomes, rather than on the quantity of services provided.

The MCOs were selected based on several criteria, including their current performance, the level of customer service delivered, member satisfaction, and their value-based performance plan. Performance criteria measured, among other things, management of chronic conditions such as high blood pressure, diabetes, and asthma; frequency of prenatal and post-partum care; and access to preventive services.

“The average performance ratings of the selected organizations are consistently higher than the current averages in every region. This transition will result in higher levels of quality care for the 2.2 million Pennsylvanians served by Medicaid,” said Dallas.

To drive Pennsylvania’s Medicaid system towards these better outcomes, the three-year agreements set gradual targets for all MCOs to increase the percentage of value-based or outcome-based provider contracts they have with hospitals, doctors, and other providers to 30 percent of the medical funds they receive from DHS. The result will be that billions in funds that would have otherwise been spent on traditional payment arrangements will instead be invested in outcome or value-based options such as:

  • Accountable care organizations (voluntary networks of hospitals, doctors, and other providers that work together to provide coordinated care to patients);
  • Bundled payments (increases value-based purchasing);
  • Patient-centered medical homes; and
  • Other performance-based payments.

“We’re going to reward folks for providing the right services, not just more services. You get what you pay for so we’re shifting the focus of Pennsylvania’s Medicaid system toward paying providers based on the quality, rather than the quantity of care they give patients,” said Dallas. “In addition, by focusing on improving the health of consumers, we will drive down the cost of care and ultimately save the taxpayer funds we spend on health care in Pennsylvania.”

HealthChoices delivers quality medical care and timely access to all appropriate services to 2.2 million children, individuals with disabilities, pregnant women, and low-income Pennsylvanians.

For more information, visit www.HealthChoicesPA.com or www.dhs.pa.gov.

DHS has selected the following MCOs to proceed with negotiations to deliver services in Pennsylvania beginning in June 2017. The agreements are awarded in five geographic regions:

Southeast Region Gateway Health
Health Partners Plans
PA Health and Wellness
UPMC for You
Vista–Keystone First Health Plan
Southwest Region Gateway Health
PA Health and Wellness
UPMC for You
Vista—AmeriHealth Caritas Health Plan
Lehigh/Capital Region Gateway Health
Geisinger Health Plan
Health Partners Plans
PA Health and Wellness
Northeast Region Gateway Health
Geisinger Health Plan
UPMC for You
Northwest Region Gateway Health
UPMC for You
Vista—AmeriHealth Caritas Health Plan

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Yesterday, a Texas federal judge issued a temporary injunction to the Department of Labor’s (DOL) overtime rule. In granting the preliminary injunction, the federal judge said the DOL’s overtime rule exceeds the authority the agency was granted by Congress.

As you may recall, the DOL’s overtime rule was announced in May, and it has been opposed by many businesses and nonprofits. The rule was to take effect on December 1 of this year. Now with yesterday’s ruling, it is likely that President-elect Trump’s administration, which opposed the rule, will have time to review it and make changes and/or roll back various provisions contained in the current rule.

The DOL could appeal the Tuesday ruling, but with the Obama administration only having approximately two months in office, an appeal is unlikely. With many RCPA members already implementing and announcing changes to comply with the DOL’s overtime rule, it might be difficult for those members to roll back these changes, because it may impact employee morale. As further information is released, RCPA will provide additional guidance to members. Please contact Jack Phillips, RCPA Director of Government Affairs with any questions.