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Authors Posts by Fady Sahhar

Fady Sahhar

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Fady is responsible for policy and regulatory matters related to Physical Disabilities and Aging, with primary focus on personal assistance, employment services, and service coordination. Emphasis is placed on engaging the Office of Long-Term Living and the Community HealthChoices Managed Care Organizations, coordination of care with Behavioral HealthChoices MCOs, and collaborations with other advocacy and provider associations. Fady is also the President / CEO of ProVantaCare, an RCPA-affiliated company focused on contracting with MCOs, and is the President of XtraGlobex, a consulting firm focused on Value-Based Payment contracting. He brings extensive experience in the advocacy and operations of human services providers in physical disabilities and aging, from his role at Liberty Resources, Inc., and his service with a number of nonprofit services providers. He earned an MBA in Marketing from The University of Tennessee and a PhD in Organizational Leadership from Capella University.

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Photo by Markus Winkler on Unsplash

The office of Medical Assistance has issued an update on EVV compliance to advise providers of changes to the manual edit thresholds for Electronic Visit Verification (EVV) records in both personal care services (PCS) and home health care services (HHCS), effective with dates of service on and after January 1, 2025.

This bulletin applies to providers enrolled in the MA Program who render PCS and HHCS to beneficiaries or participants in the MA fee-for-service (FFS) delivery system, including through home and community-based services waivers and the managed care delivery system via Physical HealthChoices or Community HealthChoices. Beneficiaries may receive services in the following programs:

  • Office of Developmental Programs (ODP): Adult Autism Waiver, Community Living Waiver, Consolidated Waiver, Person/Family Directed Support Waiver, and Base Funded Program;
  • Office of Long-Term Living (OLTL): OBRA Waiver, Act 150, and Community HealthChoices; or,
  • Office of Medical Assistance Programs (OMAP): MA FFS and Physical HealthChoices.

Read the full bulletin here. This bulletin will be a key topic at the RCPA PD&A meeting on September 11, for which you can register here.

If you have any questions, please contact Fady Sahhar or Melissa Dehoff.

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The Department of Human Services (DHS) today announced applicants selected through a Request for Applications (RFA) process to administer Pennsylvania’s Community HealthChoices (CHC) program, the Medicaid managed care program that covers adults who are dually eligible for Medicare and Medicaid or who qualify to receive Medicaid long-term services and supports due to a need for the level of care provided in a nursing facility.

Selected applicants will now move to a readiness review period before the agreements are fully executed.

The five selected plans will be available statewide. They include the three current incumbents and two plans new to Community HealthChoices:

  • Aetna Better Health of Pennsylvania
  • Health Partners Plans
  • PA Health and Wellness
  • UPMC For You
  • Vista Health Plan (AmeriHealth Caritas/Keystone First)

RCPA will be reaching out to the selected applicants to be at the upcoming PD&A meeting in September. If you have any questions, please contact Fady Sahhar or Melissa Dehoff.

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Due to significant water damage to the Honor’s Suite at 333 Market Street Tower, the Office of Long-Term Living (OLTL) is notifying the public that the September 4 and the October 2 LTSS meetings will be held via Webinar and Remote Streaming only from 10:00 am – 1:00 pm.

Register here for the September 4 webinar. After registering, you will receive a confirmation email containing information about joining the webinar. Remote captioning and streaming services will be provided. If you require these services, please visit the remote captioning and streaming services link.

Regular communication will be sent for the October 2 webinar after the September meeting.

If there are any questions, please send an email to the LTSS Subcommittee inbox.

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The Office of Long-Term Living (OLTL), with support from Mercer Government Human Services Consulting (Mercer), part of Mercer Health & Benefits LLC, is conducting a rate study survey for the following Home and Community-Based Services (HCBS):

  • Adult Day;
  • Structured Day Habilitation;
  • Employment and Training;
  • Personal Assistance (Agency);
  • Personal Assistance (Participant-Directed); and
  • Residential Habilitation.

Please complete the survey for the Calendar Year (CY) 2023, which spans from January 1, 2023, through December 31, 2023, unless it is otherwise specified. Please submit the survey by Friday, August 23, 2024. This survey is one piece of the targeted rate review and is intended to collect current provider rate and wage data and general feedback on the challenges of providing these services. The information collected in this survey will be used to assist in developing a point of reference for the rate range to evaluate current payment rates. In addition to results from this survey, the review will include payment rate information from Managed Care Organizations (MCO) in OLTL claims data, recent legislative policies, department expectations, and other data obtained from publicly available sources.

HCBS providers that delivered multiple service categories during CY 2023 should fill out this survey separately for each service category you delivered.

HCBS providers that did not deliver any of the service categories listed above should disregard this survey. OLTL is partnering with Mercer to perform a rate study exclusive to the service categories listed above at this time.

The information collected for this survey will be used for both this rate study and to meet the requirements of House Bill 1300 from the 2023–2024 Pennsylvania General Assembly regular session. The information you provide will remain confidential and private and will only be shared publicly through high level summary reports that do not include provider level detail. Please comply with the Health Insurance Portability and Accountability Act (HIPPA) and do not share any protected health information (PHI) within your survey responses.

You can review the survey questions before starting the survey. This survey tool does not allow individuals to save and go back to answer questions. Please have all your agency information such as wages, employee information, and financial statements readily available. This will help you to submit accurate information when answering the questions.

HCBS providers can access the survey here. OLTL and Mercer appreciate your time and this valuable feedback. If you have any questions or need assistance, please reach out via email. A listserv has been established for ongoing updates on the CHC program. It is titled OLTL-COMMUNITY-HEALTHCHOICES; please visit the ListServ Archives page to update or register your email address.

Please share this email with other members of your organization as appropriate. Also, it is imperative that you notify the Office of Long-Term Living for changes that would affect your provider file, such as addresses and telephone numbers. Mail to/pay to addresses, email addresses, and phone numbers may be updated electronically through ePEAP, which can be accessed through the PROMISe™ provider portal. For any other provider file changes please notify the Bureau of Fee for Service Programs Enrollment and Certification Section at 1-800-932-0939 Option # 1.

If you have any questions, please contact Fady Sahhar or Melissa Dehoff.

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