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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 a new resource for Service Coordinators (SCs) to utilize for assisting waiver participants with voting, especially with the unique challenges and health risks associated with the pandemic. This two-page document, Facilitating Voting by Home and Community-Based Services (HCBS) Participants, encourages the SCs to work with the waiver participants to develop plans for voting in the upcoming election. The document also outlines potential challenges and solutions participants may encounter in the voting process. Links for registering to vote and requesting a mail-in or absentee ballot are included in the document.

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During the October 7, 2020 MLTSS Subcommittee meeting, representatives from AmeriHealth Caritas shared information about provider education webinars planned during the month of October. The webinars are open to Home-and-Community-Based Services providers and will be conducted via Zoom on the dates below:

  • Tuesday, October 20, 2020, 10:00 am – 12:00 pm session, please register here
  • Thursday, October 22, 2020, 1:00 pm – 3:00 pm session, please register here

Advance registration is required. After registering for a session, a confirmation email will be sent that will contain information about joining the Zoom webinar.

Some of the topics that will covered include:

  • Critical incident reporting;
  • Missed visits process;
  • Claims/billing/timely filing;
  • Cultural competency;
  • And more

If there are questions about these webinars, please contact your provider Account Executive. You can locate your Account Executive information on the AmeriHealth Caritas website.

Please send your questions, comments, and feedback to this email.

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Today, the Office of Long-Term Living’s (OLTL) Bureau of Human Licensing (BHSL) sent the following notice to providers regarding the resumption of annual on-site inspections.

Per the attached Resumption of Annual Inspections During the COVID-19 Pandemic, The Office of Long-Term Living’s Bureau of Human Licensing (BHSL) has resumed annual renewal on-site inspections effective October 5, 2020.

In accordance with CDC guidance, and the Order of the Secretary of the Pennsylvania Department of Health Directing Long-Term Care Facilities to Implement Measures for Use and Distribution of Personal Protective Equipment, BHSL Licensing Representatives will be reviewing the following practices during their on-site inspections and may cite a violation if warranted:

Universal Masking

  1. Staff, including Direct Care Staff, must always wear a facemask while they are in the facility.
  2. PCH and ALR staff must also wear facemask outside where staff are unable to maintain the 6-foot social distance.
  3. Implement universal masking for everyone entering a facility (e.g., direct care staff, residents, visitors), regardless of symptoms.
  4. Residents may remove their cloth face covering/facemask when in their rooms but should put them back on when leaving their room or when others (e.g., staff, visitors) enter the room.
  5. The availability of respirator masks and ability to arrange fit-testing in the event that a resident tests positive within the facility.

Screening

  1. Screen residents and staff for fever and respiratory symptoms (using a checklist for employees such as the one developed by the American Health Care Association and the National Center for Assisted Living or as described by the CDC.
  2. Staff should be screened at the beginning of every shift. Test staff who screen positive.
  3. Residents should be screened at least daily and test any resident who exhibits fever or symptoms consistent with COVID-19.
  4. Actively screen everyone for fever and symptoms of COVID-19 before they enter the facility.

Reporting

  1. The COVID-19 Data Collection Tool is utilized to report positive test results for staff and residents, and deaths related to COVID-19 for cases identified 8/28/20 or later.
    COVID-19 Data Collection Tool User Guide
  1. The COVID-19 Tracker tool is submitted for all positive results received for staff or residents, and deaths related to COVID-19 prior to 8/28/20.
    Facility COVID-19 Tracker

If you have any questions, please contact your regional office.

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On September 30, the Oversight and Investigations Subcommittee (of the Energy & Commerce (E&C) Committee) held a virtual hearing (Pathway to a Vaccine: Ensuring a Safe and Effective Vaccine People Will Trust) with public health experts on the continued oversight of the development and safety of potential COVID-19 vaccines. Key witnesses from the hearing included:

  • Helene Gayle, M.D., M.P.H., Co-Chair, Committee on Equitable Allocation of Vaccine for the Novel Coronavirus, National Academies of Sciences, Engineering, and Medicine
  • Ashish K. Jha, Dean, M.D., M.P.H., Dean, School of Public Health, Brown University
  • Ali S. Kahn, M.D., M.P.H., M.B.A., Dean, College of Public Health, University of Nebraska Medical Center
  • Mark McClellan, M.D., Ph.D., Founding Director, Duke-Margolis Center for Health Policy, Duke University
  • Paul A. Offit, M.D., Director, Vaccine Education Center, Children’s Hospital of Philadelphia

 

The E&C website contains the videos from the hearing. The key takeaways from the hearing include:

  • There are many safeguards in place for a COVID-19 vaccine approval process;
  • All the guardrails in place should make it difficult to politicize the COVID-19 vaccine approval process;
  • The emergency use authorization process is similar to full approval;
  • Unlike Russia and China, the United States is only going to approve or authorize COVID-19 vaccines with large phase 3 clinical trials that meet high safety and efficacy standards;
  • No corners are being cut; and
  • States are not able to replicate FDA’s gold standard of vaccine review.

 

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The Centers for Medicare and Medicaid Services (CMS) continues to remind hospitals about the final rule that established requirements for hospitals to establish, update, and make public a list of their standard charges for the items and services that they provide. The goal for these actions is to promote price transparency in healthcare and public access to hospital standard charges. This requirement becomes effective on January 1, 2021. The pricing information can be provided in two ways:

  • Comprehensive machine-readable file with all items and services
  • Display of shoppable services in a consumer-friendly format

CMS has developed the following resources for providers to utilize to prepare and ensure they are compliant:

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The Centers for Medicare and Medicaid Services (CMS) recently announced that the inpatient rehabilitation facility (IRF) provider preview reports have been updated on the iQIES site and are now available for Quarter 1 of 2019 through Quarter 4 of 2019 data and the annual update of the claims-based measures data from Quarter 4 of 2017 through Quarter 3 of 2019. The information contained within the preview reports contains the data that will be published on IRF Compare during the December 2020 refresh of the website. The December 2020 refresh is the rescheduled IRF Compare refresh that was initially scheduled for September 2020.

The deadline for providers to review their data is October 26, 2020. Corrections to the underlying data will not be permitted during this timeframe; however, providers can request CMS to review the data during this preview period if they believe the quality measure scores that are displayed in their reports are inaccurate. Six new measures will be displayed publicly beginning with the December 2020 refresh and will be removing one quality measure (Percent of Residents or Patients With Pressure Ulcers that are New or Worsened) from the IRF Compare and Care Compare websites. The six new measures include:

  • Changes in Skin Integrity Post-Acute Care (PAC): Pressure Ulcer/Injury,
  • Drug Regimen Review Conducted with Follow-Up for Identified Issues – PAC IRF QRP,
  • IRF Functional Outcome Measure: Change in Self-Care Score for Medical Rehabilitation Patients (NQF #2633),
  • IRF Functional Outcome Measure: Change in Mobility for Medical Rehabilitation Patients (NQF #2634),
  • IRF Functional Outcome Measure: Discharge Self-Care Score for Medical Rehabilitation Patients (NQF #2635), and
  • IRF Functional Outcome Measure: Discharge Mobility Score for Medical Rehabilitation Patients (NQF #2636)

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Earlier this week, the Department of Health (DOH) released the COVID Alert Exposure Notification App, which is now available and can be downloaded for free in the Google and Apple stores (links provided below). The COVID Alert PA is a free mobile App using Bluetooth Low Energy (BLE) technology and the Exposure Notification System developed by Apple and Google. The app offers:

  • Interactive COVID-19 symptom checker
  • Opt-in for alerts for potential exposures to the virus
  • Updates on the latest public health data about COVID-19 in PA
  • Advice for what to do if you have a potential exposure to COVID-19

COVID Alert PA protects both privacy and personal information. The app does not use GPS, location services, or any movement or geographical information. It will never collect, transmit, or store personal information. It is completely anonymous.

Existing traditional contact tracing processes rely on a positive individual to remember and name who they have been in contact with recently, and for how long. In many cases, positive COVID-19 individuals may not even know the people they were in close contact with, like if the contact happened on a bus or train, at a check-out line in a grocery store, a restaurant or some other public venue.

The app supplements traditional contact tracing processes by being able to identify strangers a positive app user came in contact with and help stop the rapid spread of COVID-19. If the app detects that you have been in close contact with another user who has tested positive for COVID-19, you will receive a push notification on your phone. This is called an exposure alert and will be followed by what you should do to monitor your own health. You can learn more about the app and how it works here.

The Department of Human Services is committed to supporting this effort and helping protect the people we serve encouraging use of COVID Alert PA. This technology only works if others have downloaded the app, which is why they are asking all Pennsylvanians to unite against COVID and download the app.

DOH also has an extensive catalog of marketing materials including posters, social media posts, press releases, and other customizable content if you are interested in helping them to get the word out.

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The Centers for Medicare and Medicaid Services (CMS) recently announced that they will be releasing a new inpatient rehabilitation facility (IRF) Pricer software package prior to October 1, 2020. This new software package will contain updated rates that are effective for IRF claims with discharges that fall within October 1, 2020 through September 30, 2021. This Pricer software is used by providers and Medicare contractors to determine payment under the IRF prospective payment system (PPS).

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The Centers for Medicare and Medicaid Services (CMS) will conduct their next hospital/quality initiative open door forum on Thursday, September 17, 2020 at 2:00 pm. This call will focus primarily on the calendar year (CY) 2021 hospital outpatient prospective payment system (OPPS) proposed rule and the fiscal year (FY) 2021 hospital inpatient prospective payment system (IPPS) final rule. Time will also be allocated for questions.

To participate, dial 888-455-1397 and reference conference passcode: 9375124

Instant replay will be available beginning one hour after the call has ended. Instant replay is an audio recording of the call and be accessed by dialing 800-753-9736 (a passcode is not required). The recording will be available through September 19, 2020.

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