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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 Office of Long-Term Living (OLTL) has released information about the Act 150 Program sliding fee scale for calendar year (CY) 2023. This information includes:

  1. 2023 Act 150 Sliding Fee Scale;
  2. Monthly Act 150 Participant Fee Report (Age 60 and Over);
  3. Monthly Act 150 Participant Fee Report (Under Age 60);
  4. Monthly Act 150 Participant Fee Reports (Excel Version);

Please note: the bulletin’s effective date is January 1, 2023. Collection of Act 150 participant fees based on the 2023 Fee Scale must begin on the bulletin’s effective date.

The above documents are available in alternate format upon request by calling (717) 857-3280. For future reference, a copy of this bulletin will be posted to the DHS Bulletin Results page for OLTL.

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Temple University Harrisburg is offering free online training sessions that are approved to meet the Personal Care Home (PCH) and Assisted Living Residence (ALR) Administrator annual training requirements.

The training sessions are entitled:

You need only to register for one session for each topic. Please read the training announcements in full before registering to ensure you can meet the participation requirements. Please only register for these sessions if you are sure you will be able to complete them.

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.

You can email Temple University any questions you have about these trainings or if you require assistance with registration. If you would like information about additional trainings available for PCH and ALR administrators, please contact the Bureau of Human Services Licensing Operator Support Hotline.

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Image by DarkmoonArt_de from Pixabay

RCPA’s brain injury providers will begin to have quarterly meetings with the Community HealthChoices Managed Care Organizations (CHC-MCO) and are encouraged to save the following dates for these meetings:

  • April 6, 2023;
  • July 13, 2023; and
  • October 19, 2023.

The meetings will be held from 1:00 pm – 3:15 pm via webcast. During the meetings, each CHC-MCO will be allocated a 45-minute window of time. The focus of these quarterly meetings will be to have open dialogue on issues or concerns, ask questions, etc. Members will be encouraged to submit questions prior to the meeting dates.

The webcast information, which will include registration information, will be sent 30 days prior to the date of each call. Links to each call will be sent to registrants 24 hours prior to the call.

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House Republican Appropriations Chairman Seth Grove will lead a roundtable discussion with Medicaid (MA) Managed Care Organizations (MCOs) on February 7, 2023, at 10:00 am.

Committee Chairman Grove will be joined by House members and the following testifiers:

  • Emily Katz, Executive Director of PAMCO;
  • Joanne McFall, Market President of Keystone First;
  • Matthew Hurford, President/CEO of Community Care Behavioral Health;
  • James Schuster, Chief Medical Officer of UPMC Insurance Services Division;
  • Jack Carroll, Executive Director of Cumberland-Perry Drug & Alcohol Commission;
  • John Koehn, Market President of Community HealthChoices, AmeriHealth Caritas;
  • Justin Davis, Plan President/CEO of PA Health & Wellness; and
  • Brendan Harris, Vice President of Community HealthChoices, UPMC Health Plan.

The hearing will be held in Room 60 East Wing, Main Capitol, State Capitol Complex in Harrisburg. The hearing will also be streamed live.

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The monthly Managed Long-Term Services and Supports (MLTSS) Subcommittee convened on February 1, 2023. The meeting handouts included the agenda as well as the following PowerPoint presentations:

UPDATE on 02/06/23 — In addition to the above handouts, the following are now available:

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The Centers for Medicare and Medicaid Services (CMS) has updated the calendar year (CY) 2023 per beneficiary threshold amounts for therapy services. These threshold amounts, also known as therapy caps, are reflected on claims with the KX modifier to confirm that services are medically necessary as justified by appropriate documentation in the medical record. There is one amount for Physical Therapy (PT) and Speech-Language Pathology (SLP) services combined and a separate amount for Occupational Therapy (OT) services. Claims from providers for therapy services above the threshold amounts without the KX modifier are denied.

For CY 2023, the KX modifier threshold amounts are: (a) $2,230 for PT and SLP services combined, and (b) $2,230 for OT services.

For additional information, refer to CMS Transmittal 11626 and the 2023 Therapy Code List and Dispositions.

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The agenda for the February 1, 2023, Managed Long-Term Services and Supports (MLTSS) Subcommittee has been released. The meeting will be held in person at the PA Department of Education Honors Suite, 1st Floor, 333 Market Street Harrisburg, PA 17126 from 10:00 am – 1:00 pm. There is also the option to participate via webcast. The link to register to participate via webcast, as well as the remote streaming link, is available on the agenda.

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On an annual basis, the Bureau of Human Services Licensing (BHSL) provides approximately 500 hours of training for Personal Care Home (PCH) and Assisted Living Residence (ALR) administrators and staff. In order to help maximize the impact of BHSL’s training programs, members are requested to complete a ten question survey. Survey results will be kept anonymous and will be used to shape their training programs in 2023 and beyond.

This survey is intended only for administrators and staff of a licensed PCH/ALR. The survey is optional; however, your participation is strongly encouraged. The survey will be available until February 28, 2023.

Questions should be directed via email.

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