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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 Centers for Medicare and Medicaid Services (CMS) released Change Request (CR) 11055, “Annual Update to the Per-Beneficiary Therapy Amounts.” This CR provides information on the annual per-beneficiary incurred expense amounts, now known as the KX modifier thresholds, and related policy updates for calendar year (CY) 2019. These amounts were previously associated with the financial limitation amounts (therapy caps) before the application of the therapy caps was repealed when the Bipartisan Budget Act (BBA) of 2018 was signed into law.

For CY 2019, the KX modifier threshold amount for physical therapy (PT) and speech-language pathology (SLP) services combined is $2,040. For occupational therapy (OT) services, the CY 2019 threshold amount is $2,040.

Contact Melissa Dehoff, RCPA Rehabilitation Services Director, with questions.

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The United States Senate Committee on Health, Education, Labor & Pensions (HELP) recently held an executive session and voted to advance S.3657 – the Traumatic Brain Injury Program Reauthorization Act of 2018. The bill included some increased funding (from $5,500,000 to $7,321,000 for 2020 through 2014) and reauthorized the Traumatic Brain Injury (TBI) State Partnership Grant Program, which is administered by the Administration for Community Living (ACL).

The bill also created and funded a national concussion data collection and analysis program through the Centers for Disease Control and Prevention (CDC) to determine the prevalence and incidence of concussion. Contact Melissa Dehoff, RCPA Director of Rehabilitation Services, with questions.

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On November 15, 2018, the Centers for Medicare and Medicaid Services (CMS) held a National Provider Call for inpatient rehabilitation facilities (IRFs) that focused on the changes included in the fiscal year (FY) 2019 inpatient rehabilitation facility prospective payment system (IRF PPS) final rule.

CMS has posted the presentation from this call and recently posted both the audio recording and transcript. RCPA encourages all members in the Rehabilitation Services Division to listen to this recording or read the transcript from this call. Questions can be directed to Melissa Dehoff.

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During the question and answer segment of the Centers for Medicare and Medicaid Services (CMS) National Provider call that focused on the inpatient rehabilitation facility (IRF) payment and coverage policies for the fiscal year 2019 final rule on November 15, 2018, there was a response from CMS on the role of therapy students in providing care to patients in IRF hospitals and units that caused a great deal of confusion. The question related to counting minutes of therapy provided by a therapy student with guidance. The response was that these minutes would not count, regardless of the level of supervision.

Due to the amount of confusion this call has triggered, the therapy professional associations will be working with CMS on this issue and clarification will likely be forthcoming. RCPA will provide this clarification to members once this is received. Contact Melissa Dehoff, RCPA Rehabilitation Services Director, with questions.

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On Tuesday, November 27, 2018, the RAND Corporation (a contractor for the Centers for Medicare and Medicaid Services), will hold a stakeholder meeting to discuss their results from the Improving Medicare Post-Acute Care Transformation (IMPACT) Act national beta test of candidate standardized patient assessment data elements (SPADEs). They will also discuss areas of support and key concerns raised by stakeholders during prior engagement activities and answer questions from attendees.

The meeting will be held at the RAND offices, 1200 South Hayes St., Arlington, VA 22202-5050, from 12:00 pm to 4:00 pm.

Attendees can register to attend in person or by phone using the links below. The limited number of in-person spaces will be available on a first-come, first-served basis.

Contact Melissa Dehoff, RCPA Rehabilitation Services Director, with questions.

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In order to promote improved coordination between Medicare and Medicaid as the rollout of Community HealthChoices (CHC) in the Southeast portion of the state gets closer, the Office of Long-Term Living (OLTL) released a CHC Medicaid/Medicare billing fact sheet. The fact sheet includes information and answers to frequently asked questions (FAQs) regarding coverage and how billing works under CHC.

Contact Melissa Dehoff with questions.

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The Centers for Medicare and Medicaid Services (CMS) recently announced they will be holding a National Provider Call for inpatient rehabilitation facilities (IRFs) that will focus on the changes included in the fiscal year (FY) 2019 inpatient rehabilitation facility prospective payment system (IRF PPS) final rule. The call is scheduled for Thursday, November 15, 2018 from 1:30 pm – 3:00 pm.

As a reminder, some of the key changes contained in this final rule, which will be a part of this discussion, included:

  • Revisions to coverage criteria;
  • Removal of the Functional Independence Measure (FIM) and Associated Function Modifiers from the inpatient rehabilitation facility patient assessment instrument (IRF PAI); and
  • Refinements to the case-mix classification.

Prior to the call, participants are encouraged to review the Medicare Benefit Policy Manual, Chapter 1, Section 110. A question and answer session will follow the presentation; however, attendees may email questions in advance with “November 15 Call” in the subject line. These questions may be addressed during the call or used for other materials following the call.

Registration is required to participate in this call and will close by 12:00 pm on the day of the call or when it is full. RCPA encourages all of its members in the Rehabilitation Services Division to participate in this call to ask questions, share concerns, etc. with CMS.

Questions can be directed to Melissa Dehoff.

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Main Line Rehabilitation Associates, a CARF-accredited home and community-based provider that specializes in Cognitive Rehabilitation Therapy (CRT), will be hosting a free conference, “Cognitive Rehabilitation Therapy: Clinical Strategies and Evidence Based Practices.” The conference is scheduled for Tuesday, November 13, 2018 from 8:30 am – 12:00 pm and will be held at the Sheraton- Harrisburg/Hershey. Please see the flyer for additional information, including registration.

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RCPA’s Rehabilitation Services Divisions (Medical Rehabilitation Committee and Outpatient Rehabilitation Committee) will convene their first networking session in November 2018. To prepare for this session, a Survey Monkey was created to obtain member feedback on their preference for the date and topic for discussion. Members are encouraged to respond to the survey by October 2, 2018. Contact Melissa Dehoff, RCPA Rehabilitation Services Director, with any questions.

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