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Pennsylvania Capital-Star

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Pennsylvania Budget Excludes Home Health Nurse Rate Increase Despite Workforce Shortages

Pennsylvania's enacted budget does not include funding increases for home health nursing services, despite workforce shortages in the sector. Industry representatives report that current Medicaid reimbursement rates make it difficult to recruit and retain home health nurses. The budget outcome means existing rate structures will continue, affecting access to home-based nursing care for Medicaid beneficiaries. Home health agencies serving Medicaid populations face ongoing challenges competing for nursing staff without enhanced reimbursement.

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Federal Policy·48d ago

Medicaid Coverage Reinstated for Non-Abortion Services at Planned Parenthood Clinics

Federal restrictions preventing Medicaid reimbursement for non-abortion services at Planned Parenthood have ended, restoring coverage for routine healthcare provided at these clinics. States now have discretion to determine whether Medicaid enrollees can access covered services at Planned Parenthood locations that remain operational. The change takes effect immediately, reversing a previous ban that prohibited Medicaid payment for any services delivered by Planned Parenthood providers, including primary care, family planning, STI testing, and cancer screenings. Medicaid managed care organizations must now determine network participation and reimbursement policies for these providers according to state guidance.

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Legal·PA·50d ago

Pennsylvania Joins Multi-State Lawsuit Challenging Federal Medicaid Work Requirement Rules

Pennsylvania has joined a multi-state lawsuit against the Trump administration over new Medicaid work requirement rules. The litigation challenges federal restrictions on how states can handle applicants deemed medically frail, a term that lacks a standardized definition in Medicaid policy. The lawsuit represents a coordinated state effort to block implementation of the work requirement framework. This legal action creates compliance uncertainty for managed care organizations operating in participating states as they await court resolution on exemption criteria and enrollment procedures.

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State Policy·PA·69d ago

Pennsylvania Lawmakers Push PBM Oversight After 1,000+ Pharmacy Closures Since 2020

Pennsylvania has lost over 1,000 pharmacies since 2020, prompting state lawmakers to pursue legislative action targeting pharmacy benefit managers. A Pennsylvania Department of Human Services official expressed skepticism about a legislative proposal to hire a PBM to oversee other PBMs. The legislative effort aims to address pharmacy closures attributed to PBM practices, though specific proposals and timelines are not detailed in the available information.

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