On Wednesday, June 8, PA AAP advocates from across the Commonwealth descended on the PA State Capitol to urge legislators to act on three critical issues impacting pediatric practice and patients. It was an incredibly productive day thanks to the invaluable contributions of our pediatrician advocates!
The three issues on which PA AAP's advocacy focused were as follows. Please note the current status of our efforts.
1. Prior Authorization Reform: At present, prior authorization practices, which vary from insurer to insurer, delay pediatricians' ability to treat patients and jeopardizes safe, timely care. SB 225 seeks to standardize preauthorization claims by expediting health care services, creating predictable time deadlines and eliminating administrative burdens for providers. As of Wednesday, June 22, SB 225 was successfully amended (50-0) on second consideration and referred to Senate Appropriations. The bill will likely move out of Appropriations and onto final consideration by the full Senate in the last week of June (27-30). The PA AAP worked with patient advocates, hospitals, physician groups and insurers to negotiate the accepted amendments. We're eager to see SB 225 pass the full Senate soon. For more on prior authorization and SB 225, access this PA AAP resource here.
2. Early Childhood Investments: The PA AAP has joined a number of child welfare and advocacy organizations in calling on the General Assembly to prioritize investments in early childhood in the final 2022-23 budget. These investments include but are not limited to expanding postpartum Medicaid coverage, screening for postpartum depression and anxiety and instituting wage supplements for teachers and staff to ensure high-quality child care for all. See the details of the investments in a PA AAP resource here. The PA AAP will continue to urge legislators to include these investments in the final budget. Through June 30, PA AAP member advocates can join this call by visiting our Advocacy Action Center and contacting their legislators.
3. Medicaid Redeterminations: For over two years, Pennsylvania has not disenrolled recipients from Medicaid and Medicaid-expansion CHIP programs—a stipulation of the Families First Coronavirus Relief Act (FFCRA); states that received this federal funding were required to forgo coverage redeterminations for the duration of the Public Health Emergency (PHE). The PHE is likely to end in October 2022, and, of the 3.4 million Pennsylvanians covered by these programs, many aren’t aware of the threat to their coverage. Amongst other actions, PA AAP will be calling on the state to slow down the redetermination process to avoid mass disenrollment. We will also be encouraging the state to deploy a robust, multi-channel awareness campaign to ensure that enrollees know about the deadline and update their contact information to receive notices about their coverage. For more information around Medicaid and CHIP coverage renewal, click here. The PA AAP will continue to educate legislators about this threat to coverage through the end of the PHE; we encourage our advocates to do the same. Member advocates can do so through our Advocacy Action Center. Please utilize this PA AAP resource in your advocacy outreach on this subject.
To learn more about these issues and their related legislative and regulatory solutions, please take a moment to review the recent Let's Talk webinar: "Pediatric Policy Briefing," available here.
The three issues on which PA AAP's advocacy focused were as follows. Please note the current status of our efforts.
1. Prior Authorization Reform: At present, prior authorization practices, which vary from insurer to insurer, delay pediatricians' ability to treat patients and jeopardizes safe, timely care. SB 225 seeks to standardize preauthorization claims by expediting health care services, creating predictable time deadlines and eliminating administrative burdens for providers. As of Wednesday, June 22, SB 225 was successfully amended (50-0) on second consideration and referred to Senate Appropriations. The bill will likely move out of Appropriations and onto final consideration by the full Senate in the last week of June (27-30). The PA AAP worked with patient advocates, hospitals, physician groups and insurers to negotiate the accepted amendments. We're eager to see SB 225 pass the full Senate soon. For more on prior authorization and SB 225, access this PA AAP resource here.
2. Early Childhood Investments: The PA AAP has joined a number of child welfare and advocacy organizations in calling on the General Assembly to prioritize investments in early childhood in the final 2022-23 budget. These investments include but are not limited to expanding postpartum Medicaid coverage, screening for postpartum depression and anxiety and instituting wage supplements for teachers and staff to ensure high-quality child care for all. See the details of the investments in a PA AAP resource here. The PA AAP will continue to urge legislators to include these investments in the final budget. Through June 30, PA AAP member advocates can join this call by visiting our Advocacy Action Center and contacting their legislators.
3. Medicaid Redeterminations: For over two years, Pennsylvania has not disenrolled recipients from Medicaid and Medicaid-expansion CHIP programs—a stipulation of the Families First Coronavirus Relief Act (FFCRA); states that received this federal funding were required to forgo coverage redeterminations for the duration of the Public Health Emergency (PHE). The PHE is likely to end in October 2022, and, of the 3.4 million Pennsylvanians covered by these programs, many aren’t aware of the threat to their coverage. Amongst other actions, PA AAP will be calling on the state to slow down the redetermination process to avoid mass disenrollment. We will also be encouraging the state to deploy a robust, multi-channel awareness campaign to ensure that enrollees know about the deadline and update their contact information to receive notices about their coverage. For more information around Medicaid and CHIP coverage renewal, click here. The PA AAP will continue to educate legislators about this threat to coverage through the end of the PHE; we encourage our advocates to do the same. Member advocates can do so through our Advocacy Action Center. Please utilize this PA AAP resource in your advocacy outreach on this subject.
To learn more about these issues and their related legislative and regulatory solutions, please take a moment to review the recent Let's Talk webinar: "Pediatric Policy Briefing," available here.