The Community HealthChoices (CHC) Third Thursday webinar is scheduled for March 19, 2020 at 1:30 pm. Office of Long-Term Living (OLTL) Deputy Secretary Kevin Hancock will be providing updates on COVID-19. To register for the webinar, use this link.
After registering, you will receive a confirmation email containing information about joining the webinar. If you have any questions, please contact the OLTL Bureau of Policy Development and Communications Management at 717-857-3280.
The April 1, 2020 Managed Long-Term Services and Supports (MLTSS) Subcommittee meeting will now be held via webinar from 10:00 am – 1:00 pm. Public comments will be taken after each presentation. Questions can be entered into the chat box during the presentations and these questions will also be asked at the end of each presentation. There will also be a 15-minute period at the end of the meeting for any additional public comments.
To participate in the meeting via webinar, please register using the link below. A confirmation email will be sent containing information about joining the webinar. Participants are encouraged to register early.
The dial in number is: 415-655-0060 / Access Code: 201-740-620
Captionist Remote Streaming Link
If you have any questions about registering for the webinar or require a toll-free number to dial in, please contact the Office of Long-Term Living. For questions regarding this email, call 717-857-3280.
The Office of Long-Term Living (OLTL) issued the following notice regarding changes in the provider processes for the Act 150 Program and OBRA Waiver due to Coronavirus (COVID-19).
TO: Service Coordination Entities in the OBRA Waiver and Act 150 Program
The Office of Long-Term Living (OLTL) is collaborating with the Centers for Medicare and Medicaid Services (CMS) to make emergency amendments to its Home and Community-Based Waivers in response to COVID-19. To address the concerns and questions that OLTL continues to receive, the following changes in provider processes for the Act 150 program and OBRA waiver may be implemented immediately.
Service Coordination Entities (SCEs)
OLTL is providing the following guidance to SCEs regarding SC Monitoring and Individual Service Plan (ISP) Team Meetings (i.e. annual reviews, revisions, and ad hoc planning meetings). Until further notice, OLTL is permitting SCEs the flexibility to choose to conduct SC Monitoring and ISP Meetings remotely, using phone or video conferencing solutions. In those instances where the participant does not have a telephone or other electronic means of communication, the SC will document that fact and include attempts made to contact the participant in the documentation. When either of these responsibilities are completed in place of a required face to face meeting, the SC should document the occurrence.
Additionally, SCs should be working with participants to implement their Emergency Back-Up Plans. Participants are required to have an emergency back-up plan for serious emergencies that might cause a disruption in routine services being delivered to the participant for an extended period of time. This may include identifying family and friends to assist during an emergency, or finding alternative ways to receive needed services. OLTL is asking that no reductions in service plans be implemented during this time of emergency. Service additions and updated authorizations will be expected when necessary.
UPMC Health Plan is requesting essential providers to complete a COVID-19 Survey regarding the COVID-19 pandemic readiness. Surveys should be completed by March 20, 2020 and sent to this email.
Also, please contact this email address immediately if there is a change in covered services by your agency, with detailed explanation of the service being discontinued and the reason.
In response to President Trump’s declaration of a National Emergency on March 13, 2020, the Centers for Medicare and Medicaid Services (CMS) issued blanket emergency waivers (known as 1135 waivers) to certain Medicare regulations that include rules for post-acute care (PAC) providers. Included in these post-acute waivers:
Inpatient Rehabilitation Facilities (IRFs):
Waiver of 60 Percent Rule: CMS is waiving requirements to allow IRFs to exclude patients from the hospital’s or unit’s inpatient population for purposes of calculating the 60 percent rule, if an IRF admits a patient solely to respond to the emergency and the patient’s medical record properly identifies the patient as such. CMS will also, during the applicable waiver time period, apply the exception to facilities not yet classified as IRFs, but that are attempting to obtain classification as an IRF.
Acute Care Patients in IRF Units: CMS is waiving requirements to allow acute-care hospitals to house acute-care inpatients in excluded distinct part units, where the distinct part unit’s beds are appropriate for acute-care inpatient. The Inpatient Prospective Payment System (IPPS) hospital should bill for the care and annotate the patient’s medical record to indicate the patient is an acute-care inpatient being housed in the excluded unit because of capacity issues related to the disaster or emergency.
Rehabilitation Patients in Acute Care Beds: CMS is waiving requirements to allow acute-care hospitals with excluded distinct part inpatient rehabilitation units that, as a result of a disaster or emergency, need to relocate inpatients from the excluded distinct part rehabilitation unit to an acute-care bed and unit. The hospital should continue to bill for inpatient rehabilitation services under the inpatient rehabilitation facility prospective payment system (IRF PPS) for such patients and document in the medical record to indicate the patient is a rehabilitation inpatient being cared for in an acute-care bed because of capacity or pressing circumstances related to the disaster or emergency.
Skilled Nursing Facilities (SNFs): CMS is waiving the requirement for a 3-day prior hospitalization for coverage of a skilled nursing facility (SNF) stay. CMS is also providing relief to SNFs on the timeframe requirements for Minimum Data Set (MDS) assessments and transmission.
Home Health Agencies: CMS made adjustments to the timeframes for Home Health Agencies for OASIS transmissions. In addition, Medicare Administrative Contractors (MACs) have been granted permission to extend the auto-cancellation date for Requests for Anticipated Payment (RAPs) during emergencies.
CMS also made it clear that they will accept and review provider-specific requests for relief on a case-by-case basis and have provided additional information regarding how to apply for a waiver.
On March 6, 2020, the Centers for Medicare and Medicaid Services (CMS) issued Frequently Asked Questions (FAQs) for health care providers, regarding Medicare payment for laboratory tests and other services associated with the 2019-Novel Coronavirus (COVID-19). Some of the information included in this FAQ document includes:
For additional up-to-date information on the COVID-19, please refer to CMS’ Current Emergencies web page.
On Thursday, March 5, 2020, the Centers for Medicare and Medicaid Services (CMS) will conduct a call to provide information about the May 2019 expansion of the Qualified Independent Contractor (QIC) Telephone Discussion and Reopening Process Demonstration. This expansion now includes Part A providers that submit second level claim appeals (reconsiderations) to C2C Innovative Solutions, Inc. (the Part A East QIC). Topics of discussion will include benefits, who can participate, and how to participate. A question and answer session will follow the presentation. Attendees may send questions in advance via email. Please include “Appeals Demonstration” in the subject line. Additional information can be obtained from the Original Medicare Appeals web page. Members interested in participating in the call must register in advance.
The National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) recently announced a project on chronic disease management for individuals with traumatic brain injury (TBI). The objective of the project is to improve long-term health outcomes of individuals with TBI. The grantee will conduct research at the intervention – development stage, to directly inform and shape the development of chronic disease management approaches for meeting the complex and varied health care needs of individuals who have a TBI. The funding agency is the Administration for Community Living (ACL) and the award amount is $500,000. For additional information, please use this link. The closing date for interested parties is April 10, 2020.
The next Managed Long-Term Services and Supports (MLTSS) Subcommittee will convene on Wednesday, March 4, 2020 from 10:00 am – 1:00 pm at the Pennsylvania Department of Education Honors Suite, 1st floor, 333 Market Street Tower, Harrisburg, PA 17126. If you are unable to attend in person, the option to participate via teleconference is also an option. The conference line number is: 562-247-8422; PIN: 490-838-184. The agenda for this meeting is here.
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