SARS-CoV-2 Vaccine Administration by Pharmacists, December 30, 2020
- Exceptions to Maintaining Medical Assistance (MA), Including Long-Term Care (LTC) and Home and Community-Based Services (HCBS) Enrollment during the Public Health Emergency (PHE) - Coronavirus (COVID-19), December 7, 2020
- MA Benefits for Beneficiaries Turning 21 During the COVID-19 Emergency, July 2020
- Bureau of Hearings and Appeals COVID-19 Procedures , July 20, 2020
- "Payment in Full" and Personal Protective Equipment, June 12, 2020
- Pharmacy Services for Medical Assistance Beneficiaries Related to the COVID-19 Public Health Emergency, May 27, 2020
- Families First Coronavirus Response Act - COVID-19 Emergency - Revised, May 19, 2020
- MATP Consumer Notice, May 8, 2020
- MATP Guidance for COVID-19, May 8, 2020
- Managed Care Operations Memo 05-2020-12: Elective Services, May 7, 2020
- MAWD Reinstatement for Individuals Who Self-Attest to Paying Premium During the COVID-19 Emergency, May 5, 2020
- OPS-20-05-02 - "Unemployment Income & COVID-19", May 5, 2020
- COVID-19 Testing and Related Treatment Exempt from MA Copayment Requirements, May 1, 2020
- Request for State Plan Amendments Related to COVID-19, April 22, 2020
- MA Eligibility During COVID-19 Emergency, April 20, 2020
- DHS Stakeholder COVID-19 Update, April 19, 2020
- Telemedicine Guidelines Related to COVID-19, April 17, 2020
- CARES Act Economic Stimulus Payments, April 15, 2020
- Emergency Medical Assistance (EMA) during COVID-19, April 14, 2020
- New ICD-10-CM Code for COVID-19, April 13, 2020
- Families First Coronavirus Response Act - Coronavirus (COVID-19) Emergency, April 8, 2020
- Teledentistry Guidelines Related to COVID-19, April 7, 2020
- MATP Mileage Reimbursement Increase, April 7, 2020
- 90-day supplies of medications – COVID-19, April 7, 2020
- Federal Approval of PA's 1135 Waiver Request, March 30, 2020
- PA's 1135 Waiver Request Checklist & Request Letter, March 25, 2020
- MAWD Premium Payments during COVID-19 Emergency, March 25, 2020
- FAQs: MA Coverage of COVID-19 Testing & Related Services, March 24, 2020
- Cobertura de las Pruebas de Coronavirus (COVID-19) y Servicios Relacionados Bajo el Programa de Asistencia Médica: Preguntas Más Frecuentes, March 24, 2020
- Early Refills of Prescriptions, March 13, 2020
We're here to help.
Last Update: March 4, 2021
As the COVID-19 public health emergency continues, the Pennsylvania Health Law Project (PHLP) is committed to making sure those with Medical Assistance (MA) and Children’s Health Insurance Program (CHIP) coverage have services, and to securing insurance coverage for the uninsured.
PHLP staff are working remotely through the crisis and are available to counsel and represent Pennsylvanians throughout the state. Our toll-free Helpline (1-800-274-3258) remains open every Monday, Wednesday, and Friday from 8 AM to 8 PM. We can also be reached at email@example.com.
Federal & State Updates
Pennsylvania DOH Releases Vaccine Information
The COVID-19 vaccine will be distributed to Pennsylvanians in a phased approach. To learn about this phased approach, visit the Department of Health's Vaccine Site. In releasing its plans for vaccine distribution, the Department of Health noted: "Many components of the COVID-19 vaccine plan remain fluid and continue to be modified and adapted as more announcements and decisions are made at the federal level. The department is continuing to receive feedback and will be modifying this plan and posting public updates to this in the coming weeks."
Public Health Emergency (PHE) Declaration Extended
In early January, the U.S. Department of Health and Human Services renewed the federal Public Health Emergency (PHE) declaration based on the coronavirus pandemic, which was set to expire in late January 2021. This extends the federal PHE – and important Medicaid protections in place in Pennsylvania based on this authority – until at least April 20, 2021.
1. Continuous Coverage
The Families First Coronavirus Response Act requires states to provide continuous coverage for all Medicaid beneficiaries until the end of the month in which the federal PHE declaration ends. This means that most people on Medicaid must continue to receive Medicaid through April 30, 2021, even if they are no longer eligible. States can only close a person’s Medicaid coverage at their request or based on certain narrow exceptions to the continuous coverage rule.
However, Pennsylvania’s Department of Human Services (DHS) published new guidance last month that expands the exceptions under which DHS can stop a person’s Medicaid. DHS will now stop the benefit where coverage was opened through fraud or by agency error. It will also stop coverage for certain Medicaid consumers who now qualify for Medicare and the state’s Medicare Buy-In program. New Medicare beneficiaries who would not qualify for Medicaid but for the pandemic protection will now be moved to the Medicare Buy-In program. If they do not qualify for Buy-In, DHS will maintain their Medicaid until the continuous coverage protection expires.
2. Pediatric Shift Nursing “Freeze”
The extension of the federal PHE also allows Pennsylvania to continue administrative flexibilities like the protections currently in place for pediatric skilled nursing services. As one of many temporary changes approved through Section 1135 waiver authority, DHS in early April 2020 removed prior authorization requirements for many services and effectively “froze” existing authorizations for in-home pediatric skilled nursing services. Any shift nursing requests newly approved since April 2020 are also covered by these protections. State officials have confirmed in public meetings that DHS will continue the shift nursing protection for as long as the federal PHE remains in effect.
3. Beneficiaries Turning 21 Will No Longer Retain Benefits Available to Children
State officials recently announced that DHS will stop maintaining the “child” benefit package for young adults who turn age 21 on February 1, 2021. This follows a change in how federal authorities interpret the Family First Coronavirus Response Act. We had reported that states, including Pennsylvania, were required to maintain beneficiary benefit levels during the federal PHE. However, because of this policy change starting February 1st, young adults turning 21 will no longer have access to services such as private duty shift nursing and should receive a letter from DHS describing the change. If they have not transitioned into Medicaid waiver already, young adults who need long term care services (like personal care or shift nursing) in the community should apply for a Medicaid waiver program.
Please contact PHLP’s Helpline at 1-800-274-3258 (or email firstname.lastname@example.org) with any questions or if you need legal assistance maintaining these essential supports.
No Rationing Medical Care Based On Disability; Age
On March 28, 2020, the U.S. Department of Health and Human Services’ civil rights office told medical providers that they may not deny medical care to people based on their disabilities or age during the coronavirus emergency. The directive, released in a bulletin, came days after disability rights advocates filed complaints arguing that protocols to ration lifesaving medical care — adopted by Alabama and Washington State — were discriminatory.
On March 27, 2020, the Pennsylvania Medical Assistance Advisory Committee (MAAC) unanimously approved a resolution exhorting Governor Wolf to ensure that when it comes to the allocation of life-saving treatment 1) patients are not discriminated against because of their Medical Assistance Insurance status, and 2) people with disabilities are not given lower priority because of preexisting disabilities, even when those conditions require more scarce resources. The MAAC also requested that any guidelines developed be developed with the stakeholders and experts listed in the resolution, and that they be released to the public once finalized.
Governor Wolf has also stated his strong commitment to ensuring all Pennsylvanians receive fair and equitable access to lifesaving health care during the COVID-19 pandemic; and will not tolerate discrimination in the allocation of lifesaving resources based on any factor including, but not limited to age, disability and socioeconomic status.
Disability Rights Pennsylvania (DRP) has opened a Health Care Rationing Hotline during the pandemic. Individuals with disabilities who experience discrimination in health care rationing, who are denied effective communication at the hospital, or who are prohibited from bringing a needed family member or staff with them into the hospital should contact DRP's Hotline at 1-800-692-7443 ext. 402.
Medicare Part B Applications During COVID-19
In addition to mail, Medicare beneficiaries can now enroll into Medicare Part B coverage by fax, and in some cases, online.
CMS added a new online enrollment option for people age 65 or older and who have or had group health plan (GHP) coverage within the last 8 months through their or their spouse’s current employer. To apply online, you will need your Medicare number, your current address and phone number, a valid e-mail address, and documentation verifying your Group Health Plan (GHP) coverage through your or your spouse’s current employment.
To apply by fax, send the Medicare Part B form, CMS-40B and CMS L564—Request for Employment Information, along with proof of employment, GHP coverage, or Large Group Health Plan (LGHP) to the Social Security Administration at 1-833-914-2016. This information is reflected on SSA’s How to Apply for Just Medicare page. As a reminder, the applications for Part A and the Low-Income Subsidy (Extra Help) can be completed online. Source: Justice in Aging.
State Policy Documents
- FAQs: CHIP Coverage of COVID-19 Testing & Related Services, May 19, 2020
- Aviso del Programa de Seguro Médico Infantil, April 16, 2020
- Self-attestation on applications and renewals; enrolling prior to premium payment; continuation of coverage, April 1, 2020
- Early Refills of Prescriptions, March 27, 2020
- FAQs: CHIP Coverage of COVID-19 Testing & Related Services , March 26, 2020 (en español)
Guidance on COVID-19 for Personal Care Homes, Assisted Living Residences and Private Intermediate Care Facilities —
Updated September 18, 2020
- Transition Plan to Phase Out Temporary Changes to the Community HealthChoices (CHC) Waiver, June 25, 2020
- Transition Plan to Phase Out Temporary Changes to the OBRA 1915(c) Waiver, June 25, 2020
- Temporary Changes to the OBRA 1915(c) Waiver - May 8, 2020
- Temporary Changes to the Act 150 Program, May 8, 2020
- Temporary Changes to the Community HealthChoices (CHC) Waiver - Revised, April 30, 2020
- Appendix K Waiver Application, April 13, 2020
- LIFE Provider Guidance Related to COVID-19, April 8, 2020
- Electronic Visit Verification (EVV) Implementation Date, March 26, 2020
- LTSS Providers are Life Sustaining Businesses, March 23, 2020
- Interim Guidance on Visitation in Nursing Facilities During COVID-19, March 20, 2020
- Operational Recommendations for LTSS Providers, March 13, 2020
- Transition Plan to Phase Out Temporary Changes to the Community HealthChoices 1915(c) Waiver, June 25, 2020
Temporary Suspension of Specified Regulatory Requirements for Inpatient Psychiatric Services, Outpatient Psychiatric Services, Intensive Behavioral Health Services, Outpatient Drug and Alcohol Services, Mental Health Procedures, Partial Hospitalization, Intensive Case Management, Psychiatric Rehabilitation Services, Community Residential Rehabilitation Services, and Long-Term Structured Residences — August 14, 2020
COVID-19 Frequently Asked Questions (FAQs) Supplement 1 — May 5, 2020
Telehealth Guidelines Related to COVID-19 — May 5, 2020
- Instructions and Guidelines for the Delivery of BHRS and IBHS Through Telehealth, May 5, 2020
- OMHSAS COVID-19 Frequently Asked Questions (FAQs), May 5, 2020
- Suspension of Certain ODP Functions, April 3, 2020
- Behavioral Health MCOs, Fee-For-Service Providers, and County Mental Health Authorities - COVID-19 Frequently Asked Questions, March 26, 2020
- Department of Drug and Alcohol Programs (DDAP) COVID-19 Resources, March 23, 2020
- Telehealth Guidelines for All Behavioral Health MCOs, Fee-For-Services Providers, and County Mental Health Authorities, March 17, 2020
- Guidance for County Mental Health Programs, Behavioral Health Service Providers, Primary Contractors, Behavioral Health MCOs, March 14, 2020
- Enrollment Issues for COVID-19 Pandemic-Related National Emergency Q&As for Medicare Beneficiaries, May 7, 2020
- Guidance for Medicare Advantage and Part D Plans, April 10, 2020
- Video: Medicare Coverage and Payment of Virtual Services, April 5, 2020
- Coverage and Payment Related to COVID-19 Medicare, March 23, 2020
- Medicare Telehealth FAQs, March 17, 2020
- Medicare Coverage of Telemedicine: Fact Sheet, March 17, 2020
Other COVID-19 Resources
COVID-19 Resources, PALawHelp.org
Translated COVID-19 Resources, Department of Health
Stimulus Payments; Unemployment; Health Insurance Options
Health Insurance Coverage Options for People Not Working, Community Legal Services
Impact of COVID-19 Stimulus Payments and Pandemic Unemployment Benefits on Health Insurance Eligibility, Pennsylvania Health Law Project
COVID-19 Job Portal, PA CareerLink
How to Apply for Unemployment Compensation During the Coronavirus Crisis / Español / Chinese / 中文, Philadelphia Legal Assistance
Economic Stimulus Payments: Your Questions Answered, Community Legal Services
Expanded Unemployment Compensation Benefits, Northwestern Legal Services
Information for Immigrants During Coronavirus, Community Legal Services
Immigrant Eligibility for Public Programs During COVID-19: Quick Reference Guide / Español, Protecting Immigrant Families
Find a Food Pantry in Pennsylvania, Department of Human Services
Find a Food Pantry in the Philadelphia Area, Coalition Against Hunger
Coronavirus Federal Protections for Renters, Regional Housing Legal Services
No Foreclosures or Evictions Through July 10, 2020, Governor.PA.gov
How Does COVID-19 Affect My Mortgage Situation?, Northwestern Legal Services
People with Disabilities
Health Care Rationing: What Patients with Disabilities Need to Know During the COVID-19 Pandemic, Disability Rights Pennsylvania
Mental Health Resources
Get Mental Health Services in PA, Department of Human Services
Medicare Coverage & COVID-19 Webinar Recording, Justice in Aging
COVID-19 Resource Guide for Older Adults, Department of Aging
COVID-19 Resoures for Older Adults & Caregivers, Nat'l Council on Aging
- Coronavirus Updates, Department of Human Services (DHS)
- Coronavirus Updates, Office of Developmental Programs (ODP)
- Coronavirus Updates, Department of Health
- Insurance Coverage & COVID-19: FAQs, Department of Health
- Translated consumer materials, Department of Health
- Information about WIC Clinics, Department of Health
- COVID-19 Medicaid & CHIP FAQs, Centers for Medicare & Medicaid Services (CMS)
- Coronavirus Updates, Centers for Disease Control and Prevention (CDC)
- Mental Health and Coping During COVID-19, CDC
- Medicare and Coronavirus, Medicare.gov
- COVID-19: An Advocates Guide to Medicare Changes, Center for Medicare Advocacy
- Medicaid Emergency Authority Tracker, Kaiser Family Foundation
- CARES Act: Summary of Key Health Provisions, Kaiser Family Foundation
- Families First Act: Summary of Key Provisions, Kaiser Family Foundation
National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
Línea Nacional de Prevención del Suicidio: 1-888-628-9454
Crisis Text Line: Text "PA" to 741-741
Veteran Crisis Line: 1-800-273-TALK (8255)
Disaster Distress Helpline: 1-800-985-5990
- Get Help Now Hotline (for substance use disorders): 1-800-662-4357
- United Way of Pennsylvania: Text your zip code to 898-211 for resources and information in your community.