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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.

The Department of Human Services’ (DHS) Office of Long-Term Living (OLTL) has announced they will be conducting a webinar about the PA Achieving a Better Life Experience (ABLE) Savings Program on April 20, 2022, from 10:00 am–11:00 am. A PA ABLE account gives individuals with qualifying disabilities (eligible individuals) and their families and friends a tax-free way to save for disability-related expenses while maintaining government benefits. The webinar will be presented by a representative from the PA Treasury Department.

OLTL Service Coordinators (SCs), Direct Service Providers (DSPs), Community HealthChoices Managed Care Organization (CHC MCO) staff, and any individuals that work on employment are strongly encouraged to participate in this webinar, which will help you understand the PA ABLE Program and how it can benefit the OLTL participants you serve.

Please register using this registration link. After registering, you will receive a confirmation email containing information about joining the webinar.

Questions regarding this webinar should be directed to Edward M. Butler, OLTL, at (717) 214-3718 or via email.

The Office of Long-Term Living (OLTL) recently released the Request for Information (RFI) to gather feedback regarding the implementation of Agency With Choice (AWC) services for the participants of Medical Assistance (MA) managed care programs, the 1915(c) MA home and community-based services (HCBS) waiver program, and a state-funded program.

Through these programs, eligible participants receive long-term services and supports (LTSS) and other benefits, depending on the particular program. Specifically, this RFI seeks information to assist OLTL in determining how it may improve options for LTSS participants to self-direct their services in the Community HealthChoices Program (CHC), OBRA Waiver, and the state-funded Act 150 Attendant Care Program through the procurement and implementation of AWC.

Through this RFI, OLTL is seeking to become more aware of and knowledgeable about current efforts to increase opportunities for self-direction and feedback on the implementation of AWC through a potential, future procurement. OLTL encourages interested parties, including vendors and stakeholders, to provide feedback in response to this RFI or any part of it. An interested party may respond to all or any of the specific questions or topics included in this RFI.

RFI responses are due by12:00 pm on March 25, 2022. Responses must be submitted electronically with “OLTL Agency With Choice RFI” in the email subject line. While OLTL does not intend to respond to questions or clarifications during the RFI response period, interested parties and individuals may submit administrative questions related to this RFI electronically using “OLTL Agency With Choice” in the email subject line. OLTL may or may not respond based on the nature of the question.

Join us to meet Acting DHS Secretary Meg Snead, who will be providing an update on the DHS priorities for 2022, at the RCPA Physical Disabilities & Aging Divison meeting on Thursday, March 17. Register here to participate; if you have already registered, please disregard this reminder.  If you haven’t registered, please do so as soon as possible.

The meeting will be held via webcast on March 17, from 1:00 pm – 4:00 pm. Participants will hear what the latest updates are on both the federal and state levels, as well as a number of other issues impacting providers.

Note: if you have any difficulty registering, please contact Allison Brognia for assistance.

Image by DarkmoonArt_de from Pixabay

The next Financial Management Services (FMS) stakeholder meeting has been scheduled for April 1, 2022, from 1:00 pm–2:30 pm.

The purpose of this public meeting is to discuss upcoming changes for the administration of FMS under the Community HealthChoices (CHC), OBRA Waiver, and Act 150 programs. Representatives from the Office of Long-Term Living (OLTL) and CHC Managed Care Organizations (MCOs) will be in attendance to discuss upcoming changes.

Please register using this registration link. After registering, you will receive a confirmation email containing information about joining the webinar.

If you choose to use your phone to call in, please use the numbers below:
Dial in: 1 (415) 930-5321
Access Code: 847510418#
Audio PIN: shown after joining the webinar

The Brain Injury Association of America (BIAA) is offering a free webinar on the assessment and management of mild traumatic brain injury (mTBI). Dr. Chris Davlantes and Dr. Jamshid Ghajar will review the current state of mTBI assessment and management, as well as new advancements in biomarker testing. They will also provide an overview of the current standard of care, tools, and modalities, and discuss second impact syndrome.

Participants will learn about approaches and advancements in mTBI evaluation, and understand how brain injury biomarker testing can be used in conjunction with other clinical information to aid in the evaluation of suspected mTBI patients.

This free webinar is scheduled for March 22, 2022 from 12:00 pm – 1:00 pm, is sponsored by Abbott and includes 1 ACBIS CEU. Register here.

The Centers for Medicare and Medicaid Services (CMS) recently released a revised Medicare Learning Network (MLN) resource, Medicare Payment Systems, to reflect the 2022 regulation changes to payment, quality, and policy for all health settings. These include acute care hospitals, inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), home health, hospital outpatient, inpatient psychiatric facility, long-term care hospitals (LTCHs), ambulatory surgical centers (ASCs), and durable medical equipment, prosthetics, orthotics & supplies (DMEPOS).

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The Centers for Medicare and Medicaid Services (CMS) has announced a redesigned Accountable Care Organization (ACO) model that better reflects the agency’s vision of creating a health system that achieves equitable outcomes through high quality, affordable, person-centered care. The ACO Realizing Equity, Access, and Community Health (REACH) Model, a redesign of the Global and Professional Direct Contracting (GPDC) Model, addresses stakeholder feedback, participant experience, and Administration priorities, including CMS’ commitment to advancing health equity.

In addition to transitioning the GPDC Model to the ACO REACH Model, CMS is canceling the Geographic Direct Contracting Model (also known as the “Geo Model”), effective immediately. The Geographic Direct Contracting Model, which was announced in December 2020, was paused in March 2021 in response to stakeholder concerns. A comparison table of ACO REACH and GDCM is available for additional information.

CMS, through the Innovation Center, is testing new models of health care service delivery and payment to improve the quality of care that people receive, including those in underserved communities. The Innovation Center is making improvements to existing models and launching new models to increase participation in our portfolio, and CMS will be a strong collaborator to health care providers that participate in those models.”

As CMS works to achieve the vision outlined for the next decade of the Innovation Center, CMS wants to work with partners who share its vision and values for improving patient care, guided by three key principles. First, any model that CMS tests within Traditional Medicare must ensure that beneficiaries retain all rights that are afforded to them, including freedom of choice of all Medicare-enrolled providers and suppliers. Second, CMS must have confidence that any model it tests works to promote greater equity in the delivery of high-quality services. Third, CMS expects models to extend their reach into underserved communities to improve access to services and quality outcomes. Models that do not meet these core principles will be redesigned or will not move forward.

REACH ACOs will be responsible for helping all different types of health care providers — including primary and specialty care physicians — work together, so people get the care they need when they need it. In addition, people with Traditional Medicare who receive care through a REACH ACO may have greater access to enhanced benefits, such as telehealth visits, home care after leaving the hospital, and help with co-pays. They can expect the support of the REACH ACO to help them navigate an often complex health system.

The GPDC Model will continue until December 31, 2022, and then will transition to the ACO REACH Model. The first performance year of the redesigned ACO REACH Model will start on January 1, 2023, and the model performance period will run through 2026. CMS is releasing a Request for Applications for provider-led organizations interested in joining the ACO REACH Model. Current participants in the GPDC Model must agree to meet all the ACO REACH Model requirements by January 1, 2023, in order to participate.