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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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On March 1, 2024, the Centers for Medicare and Medicaid Services (CMS) posted an update on the Review Choice Demonstration for Inpatient Rehabilitation Facility (IRF) Services web page that announced they will be expanding the Review Choice Demonstration for IRF services in Pennsylvania on June 17, 2024. The demonstration will apply to IRF admissions occurring on or after June 17, 2024. IRF admissions prior to the June 17 date are not part of the demonstration, and IRF providers must select either 100% pre-claim review or 100% post-payment review between May 3, 2024, and June 2, 2024.

Medicare Administrative Contractor (MAC) for Jurisdiction L (which includes the state of Pennsylvania) is Novitas Medicare Solutions, who processes claims for IRFs located in Pennsylvania. Novitas will be directly involved in the RCD and created a dedicated RCD page on their website. The page includes additional information on background and general information, timelines, the two choices for claims review (pre-payment and post-payment), IRF RCD contact information, educational events, and other resources.

The IRF RCD began in Alabama in August 2023. CMS has cited that creating a review choice process will ensure Medicare coverage and documentation requirements are likely met. CMS feels this program will reduce the number of Medicare appeals, improve provider compliance with Medicare program rules, does not alter the Medicare IRF benefit, and should not delay medically necessary care to Medicare beneficiaries.

RCPA will continue to update members as additional information is received. Members are encouraged to review the information on the CMS RCD web page and Novitas RCD web page. Questions regarding this information can be directed to Melissa Dehoff.

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The meeting documents from the February 1, 2024, Long-Term Services and Supports (LTSS) Subcommittee meeting are now available. These documents include the transcript and PowerPoint presentations. You can view the documents below:

The next LTSS Subcommittee meeting is scheduled for March 7, 2024, from 10:00 am – 1:00 pm in the PA Department of Education’s Honors Suite at 333 Market St. in Harrisburg, PA. The option to participate via webinar is also an option. The agenda for the March meeting is available here.

To participate in the meeting via webinar, please visit here. After registering, you will receive a confirmation email containing information about joining the webinar. If you plan to participate via phone, the dial-in number is: (562) 247-8422; PIN: 871-250-554#.

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In order to avoid a potential 2 percent decrease in the annual payment update for fiscal year (FY) 2025 (October 2024 – September 2025), inpatient rehabilitation facilities (IRF) are reminded that they must submit complete data in calendar year (CY) 2023 for all quality measures that are a part of the IRF Quality Reporting Program (QRP).

IRF Patient Assessment Instrument (IRF-PAI) assessment data and data submitted via the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) for July 1 – September 30 (Q3) of calendar year 2023 must be submitted no later than 11:59 pm on February 15, 2024.

The Centers for Medicare and Medicaid Services (CMS) contractor Swingtech sends informational messages to IRFs that are not meeting Annual Increase Factor (AIF) thresholds on a quarterly basis ahead of each submission deadline. These messages were sent late last week. IRFs are encouraged to check to see if any members of their QRP team received a message from the email address “QRPHelp@swingtech.com.” If members need to add or change the email addresses to which these messages are sent, please email QRP Help and be sure to include your facility name and CCN along with any requested email updates. Any IRFs who receive a Swingtech email message are encouraged to identify and review the measures stated as missing data for Q3 2023 ASAP, and resolve any data issues by the February 15 deadline.

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Temple University has announced free online training options that have been approved to meet personal care home (PCH) annual training requirements. There are two spring 2024 training sessions with various dates to choose from. To learn more about the training sessions and to register, visit the following links:

Participation is limited for each course. 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 about these trainings or if you require assistance with registration, please email PCH Administration.

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The Department of Human Services (DHS) just announced that, due to reaching capacity in the February 9 meeting, they are adding a second session at 1:30 pm on the same day. If you are already registered for the morning session, do not register for the afternoon session so that they can keep enough space for all who are interested. Both sessions will be recorded and posted publicly to YouTube, and content will be roughly similar within the two sessions. DHS will share Question and Answer (Q&A) sessions from both, and a follow-up Q&A document will be shared next week.

Visit here to register for the afternoon session.

(If the registration link above does not work, please try copying this link directly into your browser: https://events.gcc.teams.microsoft.com/event/9f3d9e64-6d38-45a7-84eb-b0ae2b1aafd9@418e2841-0128-4dd5-9b6c-47fc5a9a1bde)

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Information was issued on January 11, 2024, regarding a second virtual transportation summit that has been planned for February 7, 2024.

Due to the original webinar not being accessible to everyone, the decision was made to change the format of the summit to a Teams virtual meeting. The meeting is open to the public, transportation providers, and anyone interested in transportation issues in the Community HealthChoices (CHC) program.

The purpose of the meeting is to have a full and robust discussion about transportation concerns and needs. There will be staff from various programs on the call, including the CHC Managed Care Organizations (MCO) and transportation brokers, MATP, and PennDOT. They will be on the call to listen to the issues and answer questions as they can.

This is a follow-up to the meeting held on December 11, 2023. This meeting will not have any formal presentations but will allow for participants, providers, and attendees to discuss their transportation issues, difficulties, or positive experiences. Participants can also ask questions during the webinar by either raising their hand and waiting until they are unmuted or by asking their question in the chat.

Attendees are encouraged to send questions or requests to speak in advance of the meeting to Cortney Alvord via email.

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