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Authors Posts by Melissa Dehoff

Melissa Dehoff

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Melissa Dehoff is responsible for all medical rehabilitation and brain injury service issues. Ms. Dehoff attends multiple state-level meetings to advocate on behalf of members on brain injury and rehabilitation issues and is a member of the Department of Health Traumatic Brain Injury Advisory Board.

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The Centers for Medicare and Medicaid Services (CMS) issued a Memorandum entitled, “Updates to the Condition of Participation (CoP) Requirements for Hospitals and Critical Access Hospitals (CAHs) to Report Acute Respiratory Illnesses,” back in October 2024. This memorandum provided updates and clarifications to the ‎Respiratory Reporting Requirements included in the FY 2025 Inpatient Prospective Payment System ‎‎(CMS-1808-F) Final Rule in the Federal Register (89 FR 68986).‎

The Memorandum provides guidance indicating that “Psychiatric Hospitals, Rehabilitation Hospitals, ‎Psychiatric Hospital Distinct Part Units, and Rehabilitation Hospital Distinct Part Units will report ‎once, annually, beginning in January, and only include the data for the previous week.”‎

The Memorandum also provides guidance on what the information collection will require:

  • One-Day-a-Week Snapshot
    • Staffed bed capacity and occupancy including adult and pediatric
    • Hospitalizations prevalence by respiratory illness and bed type
  • Weekly Total New Hospital Admissions
    • Total new hospital admissions for adult and pediatric patients by age range, over a defined weekly period

Additional information regarding the Hospital Respiratory Reporting requirements are also available on the Hospital Respiratory Data web page of the Centers for Disease and Prevention (CDC) website. The CDC will also be making changes to the reporting protocol and training information based ‎upon this modification in requirements.‎

Members are encouraged to closely review both the Memorandum from CMS and the information on the reporting requirements posted on the CDC website.

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As discussed during the RCPA Brain Injury (BI) Committee meeting held on December 5, 2024, a meeting has been scheduled with Representative Tim Briggs and Representative Ann Flood on January 13, 2025, at 11:00 am. Briggs and Flood are two of the co-chairs of Pennsylvania’s Brain Injury Caucus. An invitation was also extended to Senator Tim Kearney, another co-chair of the BI Caucus.

The primary goal for this meeting is for the BI providers and members of the BI Caucus to work in conjunction with one another. Specifically:

  • BI Caucus members will be able to hear the concerns from the BI Providers, including budget requests and access to care issues that are resulting from inadequate rates/rate increases;
  • BI providers will provide input to BI Caucus leaders on a legislative plan for the upcoming budget, such as amendments to the Safety in Youth Sports Act;
  • BI Caucus leaders will share input on how to work with legislators to achieve a common goal; and
  • Will share feedback on other issues impacting BI providers.

Members must register by sending an email to Melissa Dehoff by January 6, 2025. Registrants will receive the call information a few days prior to the scheduled call.

As part of the Brain Injury Association of Pennsylvania’s (BIAPA) Clinical Forum Series, a pediatric-specific webinar will be offered on Tuesday, December 10, 2024, from 3:30 pm – 5:00 pm. The webinar, “Formalizing a Disorders of Consciousness Program for Pediatric Patients in Inpatient Rehabilitation at the Children’s Hospital of Philadelphia (CHOP),” will discuss efforts for increased standardization of care, continuity/continuum of care, individualized components of the Disorders of Consciousness program at CHOP, discharge planning, and follow-up care.

The presenters of this free webinar are from multiple rehabilitation disciplines of the Disorders of Consciousness (DoC) program at CHOP. The session is intended for a professional audience.

Register here. For additional information, members should refer to the webinar flyer.

The 2025 meeting dates are provided below for the RCPA Brain Injury (BI) Committee meetings, as well as the Department of Human Services (DHS) Long-Term Services and Supports (LTSS) Subcommittee meetings.

RCPA’s Brain Injury Committee meetings are held both in person at RCPA and via webcast from 10:00 am – 2:00 pm.

The LTSS Subcommittee meetings will be held in the Forest Room in the Commonwealth Keystone Building, 400 North Street, Harrisburg, PA 17120, with the option to participate via webcast. The meetings are held from 10:00 am – 1:00 pm.

Members are encouraged to mark their calendars.

RCPA BI Committee Meetings

  • Wednesday, February 19, 2025
  • Wednesday, April 16, 2025
  • Wednesday, June 11, 2025
  • Wednesday, August 27, 2025
  • Wednesday, October 15, 2025
  • Thursday, December 11, 2025

LTSS Subcommittee Meetings

  • Wednesday, January 8, 2025
  • Wednesday, February 5, 2025 (virtual only)
  • Wednesday, March 5, 2025 (virtual only)
  • Wednesday, April 2, 2025
  • Wednesday, May 7, 2025
  • Wednesday, June 4, 2025
  • Wednesday, July 2, 2025
  • Wednesday, August 6, 2025
  • Wednesday, September 3, 2025
  • Wednesday, October 1, 2025
  • Wednesday, November 12, 2025
  • Wednesday, December 3, 2025

Questions about the meetings should be directed to Melissa Dehoff.

The Office of Long-Term Living (OLTL) has announced new services that will be available as a result of the Community HealthChoices (CHC) Waiver renewal and OBRA Waiver renewal. Effective January 1, 2025, the following services will be available:

Chore Services – CHC Only

  • Provider Type: 59
  • Specialty Code: 431
  • Procedure Code: S5131

Teleservice Cognitive Rehabilitation Therapy – CHC and OBRA

  • Provider Type: 59
  • Specialty Code: 207
  • Procedure Code: W0176

Teleservice Counseling Services – CHC and OBRA

  • Provider Type: 59
  • Specialty Code: 231
  • Procedure Code: W0175

Teleservice Nutritional Consultation – CHC and OBRA

  • Provider Type: 59
  • Specialty Code: 230
  • Procedure Code: W0170

The rates for the OLTL Home and Community-Based Services (HCBS) rates, effective January 1, 2025, are available here.

Additional information on the licensure and certification requirements can be found in the Service Definitions under Appendix C of the waivers. Please note that these documents have not received final approval from the Centers for Medicare & Medicaid Services (CMS). Once approval is received, a ListServ message will be sent with links to the final approved waiver applications.

The Fee for Service rates for Teleservice Cognitive Rehabilitation Therapy, Teleservice Counseling Services, and Teleservice Nutritional Consultation have been added to the fee schedule attached to the ListServ.

For existing OLTL providers to enroll in the services listed above a request must be submitted to the enrollment and certification resource account. The required documentation should include an updated Provider Enrollment Information Form (PEIF), a copy of the required license or certification, and a copy of the job description for the service you are requesting to add to your provider profile. If you have any questions related to the new services you can reach out to the enrollment and certification unit at 1-800-932-0939, option 1, or via email.

Photo by Tai's Captures on Unsplash

The Pennsylvania Department of Health (DOH) has released an updated Respiratory Virus Outbreak Toolkit for Long-Term Care Facilities, including Personal Care Homes and Assisted Living Residences.

The updated toolkit was developed to provide recommendations for facilities before and during a respiratory virus outbreak. This toolkit covers many respiratory viruses, including influenza, respiratory syncytial virus (RSV), COVID-19, adenovirus, and more. While this toolkit does include information about COVID-19, a more detailed toolkit for LTCFs specific to COVID-19 can be found here. This toolkit replaces the previous Influenza Outbreak Toolkit for Long-Term Care Facilities.

DOH is in the process of updating the poster required by the Influenza Awareness Act. In the meantime, providers are encouraged to continue to use the 2023-2024 Poster.

Questions about this communication should be sent electronically.

Image by StockSnap from Pixabay

The Long-Term Services and Supports (LTSS) Subcommittee meeting was held yesterday, November 6, 2024. During the meeting, a number of presentations were given. In addition to the presentations, the agenda and a document that provided follow-up items from the October 2, 2024, LTSS Subcommittee meeting were provided.

Members should take time to review the PowerPoint presentations from the meeting below:

The 2025 meeting dates for the LTSS Subcommittee were also shared:

  • January 8, 2025
  • February 5, 2025 (virtual only)
  • March 5, 2025 (virtual only)
  • April 2, 2025
  • May 7, 2025
  • June 4, 2025
  • July 2, 2025
  • August 6, 2025
  • September 3, 2025
  • October 1, 2025
  • November 12, 2025
  • December 3, 2025

The meetings will continue to be held from 10:00 am – 1:00 pm.

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RCPA has been notified about an interesting brain injury project in development that will benefit survivors, care partners, and professionals.

This project is being led by staff from the University of Washington, with a number of individuals from Pennsylvania working with them. The project aims to develop the National Brain Injury Network — a network connected by a website offering resources, research, and a platform for connection among those with lived experience, care partners, and health care providers. Please use this link for more information about this project.

very quick survey was developed to gather feedback that will play a crucial role in shaping the site to ensure it meets the needs and priorities of the brain injury community. Participation is voluntary and anonymous. RCPA’s brain injury providers are strongly encouraged to complete the survey and also to pass it on to others within your networks (professionals, survivors, and caregivers). If you have questions or comments, please contact the Brain Injury Network core team.

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Photo by Tingey Injury Law Firm on Unsplash

Novitas Solutions has announced that there are changes to the Amount in Controversy (AIC) for appeals filed on or after January 1, 2025. The AIC requires the claims value in dispute to meet the threshold for obtaining an Administrative Law Judge (ALJ) hearing and a judicial review in federal district court. The AIC is recalculated and published on an annual basis and is identified in a provider’s appeal notice of decision.

The AIC for appeals filed on or after January 1, 2025:

  • ALJ hearing will increase to $190.
  • Federal district court will increase to $1900.

The amount in controversy is calculated in the following manner:

  • Amount Charged minus Medicare Payments Already Made or Awarded = Subtotal Balance
  • Subtotal Balance minus Any Applicable Deductible/Coinsurance = AIC

Novitas Solutions is the Medicare Administrative Contractor (MAC) for Jurisdiction JL, which includes DC, DE, MD, NJ, and PA.

Two announcements regarding fall/winter 2024 training programs were recently released for personal care home (PCH) and assisted living residence (ALR) administrators. Both training programs are free of charge and may be counted toward the annual administrator training requirement.

The training programs include:

If you would like to participate in these online training programs, please visit the above links as well as their respective announcements to register for the courses. You need only to register for one session for each course. Please read the training announcement in full before registering to ensure you can meet the participation requirements.

Please only register for a session if you are sure you will be able to attend. Participation is limited. If you register and later discover you are unable to participate, please cancel your registration to create space for other participants.

If you have any questions or if you require assistance with registration, please email the PCH Admin inbox.