Implementation of the Family Planning State Plan Option
[45 Pa.B. 3424]
[Saturday, June 27, 2015]
The Department of Human Services (Department) is announcing its intent to seek the Centers for Medicare and Medicaid Services approval of a Family Planning State Plan option provided for under the Patient Protection and Affordable Care Act (ACA) (Pub. L. No. 111-148), effective July 1, 2015.
Since February 1, 2008, the Commonwealth has been offering family planning services and supplies to women under a Section 1115 Demonstration Waiver of the State Plan, known as SelectPlan for Women (SelectPlan). SelectPlan currently provides coverage for certain family planning services, pharmaceuticals and supplies for eligible women 18 years of age or older, but under 45 years of age, who are not otherwise eligible for Medicaid and are at or below 214% of the Federal Poverty Level.
Since the implementation of SelectPlan, the Department has seen an overall decrease in the rate of births within the Medical Assistance (MA) population, resulting in lower MA Program costs for maternity and newborn services.
Effective July 1, 2015, the Department will offer expanded family planning services through the State Plan option provided for under the ACA. The State Plan option, known as Family Planning Services, will provide family planning and family planning-related services, pharmaceuticals and supplies to men and women of any age who are not otherwise eligible for MA and meet both of the following:
• Income at or below 215% of the Federal Poverty Limit.
• Who are not pregnant.
Family planning-related services include medical diagnosis and treatment services provided in a family planning setting as part of, or as follow-up to, a family planning visit, and will include certain services for the prevention and treatment of sexually transmitted diseases.
All general MA eligibility requirements applicable to the MA Program will apply to Family Planning Service benefits, including rules relating to residence, citizenship or satisfactory immigration status and third-party insurance.
Women currently in SelectPlan will continue to receive their family planning services through SelectPlan until they are transitioned to the Family Planning Services benefit.
Interested persons are invited to submit written comments regarding this notice to the Department of Human Services, Office of Medical Assistance Programs, c/o Regulations Coordinator, Room 515, Health and Welfare Building, Harrisburg, PA 17120. Comments received within 30 days will be reviewed and considered.
Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at (800) 654-5984 (TDD users) or (800) 654-5988 (voice users).
Fiscal Note: 14-NOT-961. (1) General Fund; (2) Implementing Year 2014-15 is $0; (3) 1st Succeeding Year 2015-16 is $196,000; 2nd Succeeding Year 2016-17 through 5th Succeeding Year 2019-20 are $0; (4) 2013-14 Program—$264,179,000; 2012-13 Program—$450,835,000; 2011-12 Program—$645,095,000; (7) MA—Outpatient; (8) recommends adoption. Funds have been included in the budget to cover this increase.
[Pa.B. Doc. No. 15-1212. Filed for public inspection June 26, 2015, 9:00 a.m.]
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