Venkat’s new legislation prioritizes timeliness in processing Medical Assistance applications and reimbursing long-term care facilities

Rep. Arvind Venkat    May 22, 2024 | 3:46 PM

HARRISBURG, May 22 – State Rep. Arvind Venkat, D-Allegheny, has introduced a bill that would establish timelines for Medical Assistance applications to be approved or renewed for eligible individuals transitioning to long-term care facilities and compensate those facilities for all services provided during the application processing period.

Per H.B. 2320, the state Department of Human Services and county assistance offices would not only need to meet said benchmarks, but long-term care facilities could receive part of the funds owed to them faster and request a status update on an application(s) that is pending. The department could also end reimbursement to those facilities if a person’s Medical Assistance request is denied and claw back any previous interim payments in such circumstances.

“The goodwill of certain long-term care facilities to provide essential care and services to residents while their eligibility for Medical Assistance is determined must be a two-way street,” Venkat said. “These institutions themselves literally cannot afford to remain in perpetual limbo and face the real prospect of losing hundreds of thousands of dollars because of delays in Medical Assistance eligibility determinations. As a physician-legislator, I’m committed to keeping long-term facilities financially viable and capable of doing their great work every day.”

Venkat has also introduced legislation (H.B. 1867) that would require health insurers to offer multiple payment options to in-network health care providers for payment for clinical services and disclose any associated fees with each method of payment. The bill was recently unanimously reported out of the Pennsylvania House Insurance Committee.