Governor Shapiro unveiled his Fiscal Year 2024-2025 budget in February.  This proposal represents an 8.4% increase ($3.7 billion) over the prior fiscal year.  The Pennsylvania General Assembly will now grapple with the details with an eye towards final passage by the end of June.

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The budget document shows an 8.5% increase in the Department of Health.  Of note are three new initiatives:

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1. Ten million for the Long-Term Care Transformation Office

2. One million for Firearm Injury Prevention

3.  Four million for Medical Debt Relief

The entire budget tracking spreadsheet c

an be accessed here: 2024-25 PA Budget

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What we're watching...

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Medical Licensure Compact Act

Although Pennsylvania enacted a medical licensure compact act in 2016, it remains to be one of four states that continues to experience delays in implementation due to language concerns with the FBI over background checks.  Once this obstacle is removed, final enactment will take place directly. We are tracking impact on otolaryngology.

 

Septoplasty

In December 2023, Highmark BC/BS issued a Policy Directive that stated that a twelve week course of either an intranasal antihistamine or intranasal steroid would be required prior to procedure approval.

 

In February, Highmark issued a Policy Update that reduced the treatment course from twelve weeks to four weeks before approval would be granted.  This policy change is to become effective on May 27, 2024.

 

PAO, with AAO, is working on letters to Highmark, the Pennsylvania Insurance Commission, and the Senate and House Insurance Committees to indicate opposition to this policy change. 

 

Another septoplasty issue has arisen lately, Highmark’s refusal to reimburse for debridements after sinus surgery.  Highmark claims that this procedure is not just part of post-operative care.  This issue will be further flushed out with PAO actively expressing concerns with this issue.

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​2024 General Assembly Session Dates 

 

STATE HOUSE OF REPRESENTATIVES

June 3, 4, 5, 10, 11, 12, 17, 18, 24, 25, 26, 27, 28
 

STATE SENATE

June 3, 4, 5, 10, 11, 12, 24, 25, 26, 27, 28, 29, 30