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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 Pennsylvania Department of Vocational Rehabilitation (OVR) and Temple University will be conducting an upcoming PA Business-to-Business Mentor Network event on how organizations can be more inclusive specific to hiring people with disabilities.

The webinar will be held on May 23, 2024, from 10:00 am – 11:00 am. Additional information, as well as a link to register, is available in the flyer here.

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The Centers for Medicare and Medicaid Services (CMS) has announced the next Medicare Updates and Education webinar. The webinar, “Medicare & Other Programs for People With Disabilities,” is scheduled for May 9, 2024, from 1:00 pm – 2:30 pm and will include information about:

  • What’s Happening in Medicare – May 2024;
  • NTP Announcements and Resources;
  • Women’s Health Week (May 12 — May 18);
  • National Osteoporosis Prevention Month;
  • World No Tobacco Day (May 31);
  • Older Americans Month;
  • Arthritis Awareness Month;
  • Mental Health Awareness Month; and
  • Coverage to Care.

To participate, please register here.

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On April 24, 2024, Novitas Solutions hosted their first webinar for inpatient rehabilitation facilities (IRF) in preparation for the start date of the IRF Review Choice Demonstration (RCD) in Pennsylvania on June 17, 2024. Novitas is the RCD contractor for the state of Pennsylvania. The webinar provided an overview of the process, the different review choices, and the instructions for contractor-specific portal (Novitasphere). While the webinar primarily covered the basics of the program as previously laid out in CMS’s materials, there was some new information that was shared:

  1. For the first time, Novitas introduced the clinical leadership team for the demonstration in Pennsylvania:
    • Ene Ojile, the Contract Medical Director overseeing the RCD in Pennsylvania. Dr. Ojile is Board-Certified in Physical Medicine & Rehabilitation (PM&R), and she most recently served as Medical Director for a large freestanding inpatient rehabilitation hospital.
    • Jessica Hicks, RN, MSN, the Medical Review Manager.
    • Mia Jackson, RN, BSN, the Medical Review Team.
  2. There was some discussion and confusion about the methodology Novitas will use to calculate individual hospital’s affirmation rates under the RCD. During the webinar, Novitas staff stated that the total number of submissions and resubmissions would be included in the calculation, potentially penalizing hospitals for completing resubmissions even if the claim is eventually affirmed. After the webinar, Novitas circulated a “clarification” indicating that, “The number of resubmissions is not counted against the affirmation rate.” Additional clarification will be requested to confirm how the rates will be calculated and that the same methodology will be used as in Alabama.

The slides from the April 24 webinar are now available, and Novitas has also posted a recording of the main presentation (without the public Q&A portion) available here.

Novitas will also be hosting the following training and education webinars leading up to the start date. You can register for these webinars at their website.

  • May 2 — Review Choice Selection & Process (PA IRF Providers Only)
  • May 3 — RCD: How to Prepare (All JH and JL IRF Providers)
  • June 4 — Pre-Claim and Post-Payment Review Submissions (PA IRF Providers Only)

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The Department of Human Services (DHS) has released the report Recommendations for Improving Self-Direction in Community HealthChoices. The purpose of this report is to provide Community HealthChoices (CHC) stakeholders with identified barriers and recommendations to improve and increase the use of self-direction in CHC. View the report here.

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RCPA’s Brain Injury Committee will conduct an exclusive meeting with representatives from the Office of Long-Term Living (OLTL), including Deputy Secretary Juliet Marsala and Director of the Bureau of Coordinated and Integrated Services Randy Nolen. This meeting has been scheduled for May 22, 2024, at RCPA’s office, and will be held from 10:30 am – 12:00 pm. While this will be a hybrid meeting, members are encouraged to attend in person if possible. Register for the meeting here.

We are asking members to send topics and/or questions to Melissa Dehoff by May 8, 2024.

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The Office of Long-Term Living (OLTL) hosted a virtual Transportation Summit on December 11, 2023. Answers to questions asked during that webinar can be found on the Community HealthChoices (CHC) Communications to CHC Participants web page under the heading “Community Meetings/Information Sessions.” The Q&A document is also available here.

Questions about CHC transportation provided through a CHC managed care organization (MCO) should be directed to the CHC-MCO through one of these methods:

​AmeriHealth Caritas Pennsylvania Website
Phone: 1-855-235-5115 (TTY 1-800-235-5112)
Questions? Submit inquiries through this contact form.

​Keystone First Website
Phone: 1-855-332-0729 (TTY 1-855-235-4976)
Questions? Submit inquiries through this contact form.

​PA Health & Wellness Website
Phone: 1-844-626-6813 (TTY 711)
Questions? Submit inquiries through this contact form.

​UPMC Community HealthChoices Website
Phone: 1-844-833-0523 (TTY 711)
Email

Questions about the Medical Assistance Transportation Program (MATP), including how to contact your local MATP provider, information is found on the MATP website.

For information on the Pennsylvania Department of Transportation (PennDOT) Shared-Ride Program, please visit the Seniors and Persons With Disabilities web page.

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The agenda for the May 8, 2024, Long-Term Services and Supports (LTSS) Subcommittee meeting has been released. View the agenda here.

As a reminder, the meeting is being conducted in person and as a webinar with remote streaming from 10:00 am – 1:00 pm at the Honors Suite, 1st Floor, at 333 Market Street Tower, Harrisburg, PA. Additional information, including the conference line numbers, webinar links, etc. are provided below:

Comments and questions may be sent via email.
Conference line:
Bridge Number: 1-562-247-8422
PIN: 573-997-798#

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Hole torn in a dollar bill with medicaid text

On April 25, 2024, at 12:00 pm, a virtual statewide briefing will be conducted on Medicaid unwinding and expanded enrollment options. This event will feature Health and Human Services (HHS) Regional Director Melissa Herd, Pennsylvania Department of Human Services Secretary Val Arkoosh, and Pennie Executive Director Devon Trolley.

The agenda will include a briefing on what’s happening at the federal level when it comes to Medicaid, an update on the Medicaid “unwinding” process currently wrapping up in Pennsylvania, and the expanded eligibility requirements for enrolling in Pennie coverage even when it’s not open enrollment.

To register, please visit here.

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