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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.

On October 27, 2020, the Office of Long-Term Living (OLTL) notified all providers that interim reporting of COVID-19 related costs under Act 24 would be due on November 6, 2020. Because of unforeseen delays in web portal user provisioning for OLTL providers and recognition that this delay may not allow enough time for providers to gather and report their data, OLTL has changed its reporting requirements. There will be no interim report required of non-nursing facility providers. In preparation for final reporting on the use of Act 24 funding, now due December 21, 2020, OLTL recommends that providers begin to populate the applicable Excel reporting template now.

OLTL will offer a webinar to give non-nursing facility providers a chance to ask questions about reporting COVID-19 related costs under Act 24. Information about the webinar, including date and time, will be issued in the near future.

As a reminder, providers are advised to review the guidance for eligible COVID-19 costs in DHS’s Frequently Asked Questions and on the following US Department of Treasury websites: Coronavirus-Relief-Fund-Guidance and Coronavirus-Relief-Fund-Frequently-Asked-Questions. These documents outline the conditions and acceptable uses of Cares Act and Act 24 funding. Most importantly, the deadline by which costs must be incurred to be eligible under Act 24 is November 30, 2020.

Any provider who does not expect to use all or part of the Act 24 funding may return the funds to OLTL at:

PA Department of Human Services
Office of Long-Term Living

PO Box 8025

Harrisburg, PA 17105-8025

Please send any remaining questions about OLTL Act 24 reporting here.

The Department of Health and Human Services (HHS) recently released updated Provider Relief Fund Frequently Asked Questions (FAQs) for phase 3 of the general distribution of provider funds. The document includes updated questions and answers. It also includes information on corrections of data entered by recipients after application submission, use of funds for salaries and employment compensation, reporting the calculation of lost revenues attributable to COVID-19, and defining the term “health care related expenses.”

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The Centers for Medicare and Medicaid Services (CMS) has released a video tutorial for providers in Inpatient Rehabilitation Facilities (IRFs) with standardized data assessment guidance and assessment strategies for the cognitive assessment—known as the Brief Interview for Mental Status (BIMS). The video is approximately 22 minutes in length and is designed to provide targeted guidance for accurate coding by using live action patient scenarios.

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The Office of Long-Term Living (OLTL) issued an updated guidance and tool that was previously issued on October 13, 2020 regarding the temporary closure and re-opening of settings. This guidance and tool were issued to support providers in their efforts to protect against community spread of COVID-19. The Community Spread Thresholds document has been updated on page two to show that the “Thresholds for Community Spread” section is not applicable to Structured Day Programs. Members should disregard the previous communication.

 

Today, the Trump Administration released a comprehensive plan that includes proactive measures to remove regulatory barriers and ensure coverage and payment for the administration of an eventual COVID-19 vaccine. To ensure broad access to a vaccine (especially for seniors), the Centers for Medicare and Medicaid Services (CMS) released an Interim Final Rule with Comment Period (IFC) that establishes that any vaccine that received Food and Drug Administration (FDA) authorization, will be covered under Medicare as a preventive vaccine at no cost to beneficiaries. The IFC also implements provisions of the CARES Act that ensures immediate coverage of a COVID-19 vaccine by most private health insurance plans without cost sharing from both in and out-of-network providers during the course of the public health emergency (PHE).

CMS also released a set of toolkits for providers, states, and insurers to help the health care system prepare to swiftly administer the vaccine when available. These resources are designed to increase the number of providers that can administer the vaccine and ensure adequate reimbursement for administering the vaccine in Medicare while making private insurers and Medicaid programs aware of their responsibility to cover the vaccine at no charge to beneficiaries.

Additionally, CMS released new Medicare payment rates for COVID-19 vaccine administration. The Medicare payment rates will be $28.39 to administer single-dose vaccines. For a COVID-19 vaccine requiring a series of two or more doses, the initial dose(s) administration payment rate will be $16.94 and $28.39 for the administration of the final dose in the series. These rates will be geographically adjusted and recognize the costs involved in administering the vaccine, including the additional resources involved with required public health reporting, conducting important outreach and patient education, and spending additional time with patients answering any questions they may have about the vaccine. Medicare beneficiaries, those in Original Medicare or enrolled in Medicare Advantage, will be able to get the vaccine at no cost. CMS is encouraging state policymakers and other private insurance agencies to utilize the information on the Medicare reimbursement strategy to develop their vaccine administration payment plan in the Medicaid program, CHIP, the Basic Health Program (BHP), and private plans. Using the Medicare strategy as a model would allow states to match federal efforts in successfully administering the full vaccine to the most vulnerable populations.

The IFC (CMS-9912-IFC) is scheduled to display at the Federal Register as soon as possible with an immediate effective date and a 30-day comment period.

Additional information on this IFC can be found in the fact sheet.

The COVID-19 vaccine resources for providers, health plans, and State Medicaid programs can be found here.

The FAQs on billing for therapeutics can be found here.

a memo is on the keyboard of a computer as a reminder: meeting

The Managed Long-Term Services and Supports (MLTSS) Subcommittee meeting agenda for the November 4, 2020 meeting has been released. The meeting is scheduled for 10:00 am – 1:00 pm and will be held via webcast. The information to participate is available below:

Webinar Link: https://attendee.gotowebinar.com/register/9164975178583542541
Public Call in # and Pin: 1-415-655-0060 Pin: 753-009-978
Remote Streaming Link: https://2020archive.1capapp.com/event/mltss

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During this discussion session on Thursday, October 29, 2020, from 12:15 pm – 1:00 pm, focus will be spent on the recent evolution of telehealth in the inpatient rehabilitation facility and the outpatient rehabilitation setting and how your organization is adapting to the many changes. From the days when telehealth wasn’t readily recognized or paid for to quickly implementing it in response to the COVID-19 outbreak, our discussion will focus on where we are currently and where we go post-pandemic. Some of the topics that we will discuss include:

  • What have we learned?
  • What have your outcomes been?
  • Barriers – then and now
  • Staffing, payment, etc.
  • Virtual assessments & phone assessments
  • Data Collection
  • Validity/reliability of standardized measures
  • Goal setting
  • Privacy Issues
  • Feedback from patients & family members
  • Where do we go from here?

Please share this invitation with all relevant staff.

**RSVP via email to Melissa Dehoff by October 23, 2020, providing the following information in your response:

Name:
Organization:
Contact Info (Email/Phone):

Call information and final agenda will be sent to registrants 1–2 days prior to the discussion session.

If you have any questions about this discussion session, please contact Melissa Dehoff.

a memo is on the keyboard of a computer as a reminder: meeting

The Managed Long-Term Services and Supports (MLTSS) Subcommittee meeting transcript from the October 7, 2020 meeting has been posted. The next MLTSS Subcommittee is scheduled for Wednesday, November 4, 2020 from 10:00 am – 1:00 pm and will be held via webcast. The information to participate is available below:

Today, the Centers for Medicare and Medicaid Services (CMS) announced they have expanded the list of telehealth services that Medicare Fee-for-Service (FFS) will pay for during the COVID-19 public health emergency (PHE). CMS is also providing additional support to state Medicaid and Children’s Health Insurance Program (CHIP) agencies as a part of their efforts to expand access to telehealth.

CMS is adding eleven new services to the Medicare telehealth services list since the initial publication of the May 1, 2020 COVID-19 interim final rule (IRF) with comment period. Medicare will begin paying eligible practitioners who furnish these newly added telehealth services effective immediately, and for the duration of the PHE. These new telehealth services include certain neurostimulator analysis and programming services, and cardiac and pulmonary rehabilitation services.

In an effort to provide greater transparency on telehealth access in Medicaid and CHIP, CMS is releasing, for the first time, a preliminary Medicaid and CHIP data snapshot on telehealth utilization during the PHE. This snapshot shows, among other things, that there have been more than 34.5 million services delivered via telehealth to Medicaid and CHIP beneficiaries between March and June of this year, representing an increase of more than 2,600% when compared to the same period from the prior year. The data also shows that adults ages 19-64 received the most services delivered via telehealth, although there was substantial variance across both age groups and states.  Additionally, CMS is releasing a new supplement to its “State Medicaid & CHIP Telehealth Toolkit: Policy Considerations for States Expanding Use of Telehealth, COVID-19 Version,” which provides numerous new examples and insights into lessons learned from states that have implemented telehealth changes. This updated information is intended to assist states strategically think through how they explain and clarify to providers and other stakeholders which policies are temporary or permanent. It also helps states identify services that can be accessed through telehealth, which providers may deliver those services, the ways providers may use in order to deliver services through telehealth, as well as the circumstances under which telehealth can be reimbursed once the PHE expires.

The toolkit includes approaches and tools states can use to communicate with providers on utilizing telehealth for patient care. It updates and consolidates in one place the frequently asked questions and resources for states to consider as they begin planning beyond the temporary flexibilities provided in response to the pandemic.

 

Pennsylvania’s Department of Human Services (DHS) and Department of Aging have issued a guidance document, “Community Spread Thresholds – Closure for Staff and COVID and Reopening Tool,” and a tool entitled “Community Participation Support and Older Adult Facility – COVID-19 Closure Reopening Tool,” to support providers in their efforts to protect against community spread of COVID-19. DHS and the Department of Aging will be sharing these documents with Service Coordinators (SCs) to use as references.