OLTL Guidance for Adult Daily Living Providers for Additional Appendix K Flexibilities
Melissa Dehoff
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.
Regional Response Health Collaborative Program Transitions to RCAT to Continue COVID-19 Support
On May 29, 2020, Pennsylvania’s State Legislature appropriated $175 million dollars from the federal CARES Act to protect residents and staff in long-term care facilities (LTCFs). With this funding, and in partnership with select health systems, Pennsylvania’s Long-Term Care Task Force (LTC-TF) developed the Regional Response Health Collaborative (RRHC) program. Federal funding for the RRHC program ended on December 30, 2020.
Due to federal dollars no longer being available and a constrained state budget, the Wolf Administration has prioritized the allocation of limited funds to continue providing facilities with support during COVID-19 facility outbreaks. This state-funded effort will leverage the expertise of the health systems through the Regional Congregate Care Assistance Teams (RCAT), a new, more limited version of the RRHC. Starting on December 31, 2020 and lasting through February 28, 2021, the RCAT will provide COVID-19 outbreak support to facilities. Those facilities who were eligible for the RRHC program will also be eligible for the RCAT.
- Continued supports that will be offered to the RCAT-eligible facilities are:
- Call centers currently utilized under the RRHC program will remain available to engage health systems for infection control/prevention services and education in the event of COVID-19 outbreaks. (Facilities located in Carbon, Pike, Monroe, Lehigh, and Northampton Counties, please refer to the chart below for updated call center information).
- Personal protective equipment (PPE) will be provided by existing and new vendors. Refer to the chart below to request assistance.
- Staffing assistance will continue to be provided by existing and new contracted agencies as well as the PA National Guard, but it will be more limited.
- Testing assistance is available as resources permit through the Pennsylvania Department of Health’s (DOH’s) vendors. Facilities experiencing a current outbreak or support from a RRHC or DOH vendor will be enrolled in testing support first, and then the program will expand based on the availability of resources.
- Tomorrow’s Healthcare portal will still be accessible; webinars will be scheduled as needed.
With the introduction of the RCAT, coverage remains the same as the RRHC program except for the Northeast Region. Engagement with LECOM, UPMC (including Allegheny Health Network, Excela, Penn Highlands, and St. Clair), Penn State, University of Pennsylvania (including Temple), and Thomas Jefferson (including Main Line Health) will remain the same. Geisinger will continue to provide coverage for the Northcentral region and has expanded to support Carbon, Monroe, and Pike Counties as well. The LTC-TF will backstop RCAT support across the commonwealth and ensure support for facilities located in Lehigh and Northampton Counties.
Some services provided by the health systems have changed. Members are encouraged to refer to the updated contact list.
Regional Response Health Collaborative Program Update Issued
Today, a joint guidance was issued by the Pennsylvania Department of Health (DOH) and the Department of Human Services (DHS) about the Regional Response Health Collaborative Program (RRHCP). The guidance includes a number of frequently asked questions (FAQs).
Department of Health COVID-19 Vaccine Information
The Pennsylvania Department of Health (DOH) has a website that is dedicated strictly to the COVID-19 vaccine. Members are encouraged to save this page due to the valuable and important information regarding the vaccine that is posted there on a regular basis. This information includes a number of frequently asked questions (FAQ’s), a link to the COVID-19 vaccine provider locations, and much more.
CMS Issues COVID-19 Add-On Payment for New Treatment Interim Final Rule
The Centers for Medicare and Medicaid Services (CMS) has released an Interim Final Rule with Comment Period that will establish a new COVID-19 treatments add-on payment (NCTAP) under the Medicare Inpatient Prospective Payment System (IPPS), which is effective from November 2, 2020, until the end of the Public Health Emergency (PHE) for COVID-19. To mitigate potential financial disincentives for hospitals to provide new COVID-19 treatments during the COVID-19 PHE, the Medicare program will provide an enhanced payment for eligible inpatient cases that involve the use of certain new products with current Food and Drug Administration (FDA) approval or emergency use authorization to treat COVID-19. Comments will be accepted until the close of business on January 4, 2021.
CMS Issues CY 2021 Update for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Fee Schedule
The Centers for Medicare and Medicaid Services (CMS) issued Medicare Learning Network (MLN) Matters article MM12063 entitled “Calendar Year (CY) 2021 Update for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule”. It becomes effective on January 1, 2021. This article includes material on the data files, update factors, and other information related to the update of the fee schedule. The DMEPOS fee schedule is updated on an annual basis. For CY 2021, an update factor of 0.2 percent is applied to certain DMEPOS fee schedule amounts. Additional details specific to supplies are provided in the article.
Next MLTSS Subcommittee Meeting to Be Held on January 5, 2021
The Office of Long-Term Living (OLTL) recently announced the date of the next Managed Long-Term Services and Supports (MLTSS) Subcommittee meeting. The meeting will be held as a webinar on January 5, 2021 from 10:00 am – 1:00 pm.
To participate in this webinar, members should register prior to the call. After registering, a confirmation email that contains the information about joining the webinar will be sent. If you are unable to join via webinar, the dial-in information is below:
Dial-In Number: 1-(914)-614-3221 Access Code: 660-883-807
CMS Delays MIPS Application Deadline Until February 1
To further support clinicians during the COVID-19 Public Health Emergency (PHE), the Centers for Medicare and Medicaid Services (CMS) has extended the 2020 Merit-Based Incentive Payment System (MIPS) Extreme and Uncontrollable Circumstances Exception application deadline until February 1, 2021.
For the 2020 performance year, MIPS eligible clinicians, groups, and virtual groups can submit an application requesting for CMS to reweight one or more performance categories to zero percent due to the current COVID-19 PHE. If members have concerns about the effect of the COVID-19 PHE on your performance data, including cost measures, submit an application and cite COVID-19 as the reason for your application.
For additional information, consult the following resources:
- MIPS Extreme and Uncontrollable Circumstances Exception Application User Guide and Fact Sheet
- How to Submit an Extreme and Uncontrollable Circumstances Exception Application Video
- Extreme and Uncontrollable Circumstances Exception Webpage
- Quality Payment Program Exceptions Application Fact Sheet
DHS Launches Online Portal for Tracking CARES Act Funding
Today, the Department of Human Services (DHS) is launching an online portal (called the DHS CARES Act Funding Tracking Tool) for Office of Long-Term Living (OLTL) providers to submit final costs in compliance with Act 24 of 2020 (CARES Act funding). DHS is requesting that providers complete the COVID-19 Act 24 cost reporting form and upload it through the online portal. Providers must keep all documentation related to the costs reported in the final cost report for a minimum of five years. The due date for the submission of the required final report has been extended to December 31, 2020.
To assist providers, DHS has provided the following guidance and tips:
- Username and Password Credentials
- If you are a new user, you will receive two emails from PW, Unified Security inbox The first email will contain your username. The second email will contain your temporary password for first-time sign in.
- If you have an existing Commonwealth Business Partner account (“b-” ID), you will receive a username reminder email tomorrow. Please use this username to login to the tool.
- Updating Provider Contact
- If you will not be completing the final report for your organization and would like to change the user associated, please complete the DHS COVID Tracking – User Change Request form to start the process to set up their credentials. Note that this process may take a few business days.
- Attestation
- When completing the report for your entity, an attestation is required. The attestation language is as follows: I, [ENTER NAME OF PERSON WITH THE AUTHORITY TO SIGN ON BEHALF OF THE LEGAL ENTITY BELOW], certify, subject to the terms and penalties of 18 Pa. C.S. §4904 (relating to unsworn falsification to authorities), that the information contained in the forgoing Act 24 Cost Reporting Form is true and correct to the best of my knowledge following reasonable investigation, that the entity that I represent was in operation as of March 31, 2020, as required by Act 24 of 2020; and that the Act 24 of 2020 funds were used to prevent, prepare for, and respond to the coronavirus pandemic and reimburse health-care-related expenses or lost revenues attributable to the coronavirus pandemic; and that the Act 24 of 2020 funds were not used for expenses or losses that have been or will be reimbursed from other sources.
- Final Report Template
- Providers are required to upload the completed Excel template when completing the final report in the online portal.
- Online Portal Training and Support
- Providers will receive a detailed DHS CARES Act Funding Tracking Tool Final Report User Guide with frequently asked questions (FAQs) on the launch date to help you navigate the new tool, answer any questions you may have, and provide troubleshooting information on browsers and passwords.
- Act 24 of 2020 Information
- Governor Wolf signed Act 24 of 2020, which allocates funding from the Federal Coronavirus Aid, Relief, and Economic Security Act – also known as the CARES Act – to assist providers with COVID-19 related costs. Funding from Act 24 must be used to cover necessary COVID-19 related costs incurred between March 1, 2020 and November 30, 2020 that have not been otherwise reimbursed by federal, state, or other sources of funding. To qualify for the one-time payment, a person or entity must have been in operation as of March 31, 2020. Under Act 24, $457 millionof COVID-19 relief funds were allocated to providers in OLTL programs.
- Any person or entity accepting a COVID-19 payment must provide documentation to DHS, upon request, for purposes of determining compliance with Act 24 requirements. Providers were previously advised to keep documentation to demonstrate how the funds were used for a response to the COVID-19 pandemic in case of an audit.
- Providers are advised to review guidance such as the following for eligible COVID-19 costs on the US Department of Treasury website: Coronavirus-Relief-Fund-Guidance and Coronavirus-Relief-Fund-Frequently-Asked-Questions. DHS guidance is also available in DHS Frequently Asked Questions.
Please Note: if you received a payment under Act 24 of 2020 from more than one Pennsylvania DHS program office, you may receive this notification more than once. However, you will only receive one login to the online portal and will be able to submit for all program offices and facilities at the same time.
CMS Call Scheduled Concerning Physician Fee Schedule Final Rule Provisions
The Centers for Medicare and Medicaid Services (CMS) has announced that they will hold a call on December 10, 2020 from 1:30 pm – 3:00 pm Eastern Time (ET) that will focus on the calendar year (CY) 2021 Medicare Physician Fee Schedule (MPFS) final rule that was recently released. This call will focus specifically on four key areas within this final rule, including:
- Extending telehealth and licensing flexibilities beyond the public health emergency (PHE);
- Updating Evaluation and Management (E/M) coding guidance;
- Updating the Quality Payment Program and Merit-Based Incentive Payment System Value Pathways; and
- Updating opioid use disorder and substance use disorder provisions.
During the call, CMS experts will briefly cover provisions from the final rule and address any questions. Members are encouraged to review the final rule prior to the call. To participate, please register here.
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