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OVR’s quarterly board meeting is scheduled for this Thursday, December 1, 2022, from 9:00 am – 1:30 pm, and is a hybrid meeting. The physical meeting location is at the Best Western Premier Hotel outside of the city of Harrisburg (800 East Park Drive, Harrisburg, PA 17111), off Route 83, Exit 48. View the meeting link, information, and agenda here.

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Due to requests for extension to submit the ID/A Workforce Compensation Survey, we are pleased to announce completed surveys will now be accepted through Friday December 2. This survey is a collaborative effort between The Center for Healthcare Solutions (C4HS), The Arc of Pennsylvania, Rehabilitation & Community Providers Association (RCPA), and The Provider Alliance (TPA).

The results of this survey will be critical to validate the need for further investment in community ID/A services. Rate-setting issues such as no inflation factor, setting wages at the 25th percentile, and the application of a 5% overtime factor require data and analysis to refute key rate assumptions.

You can download the survey here. Please forward completed surveys to Steve Forest by December 2, 2022. The comprehensive published report will be released on January 3, 2023.

A collaborative session to provide background and technical assistance on the survey was held on November 2. If you were unable to join, you can access a recording of the session here.

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The Pennsylvania Department of Drug and Alcohol Programs (DDAP) is awarding $9 million to single county authorities (SCAs) to establish or expand crisis stabilization services for individuals who present with substance use disorder (SUD) and co-occurring mental health symptoms. Such services include assessment and stabilization of acute physical and psychiatric symptoms, which may include medical management and behavioral interventions, induction on medication-assisted treatment, level of care assessments, short-term stays, and connections to supportive services.

Grants of up to $3 million will be awarded to eligible SCAs and can be applied toward a range of activities, including construction and building infrastructure, staffing, and programming. The SCAs may provide or coordinate the services.

SUD crisis stabilization services must have the capacity to recognize and manage individuals presenting with a wide range of SUD-related symptoms, mental health disorders, and developmental disabilities. Funds can be applied toward a range of activities, including construction and building infrastructure, staffing, and evidence-based programming.

Earlier this year, the General Assembly allocated its 2022 $17 million portion of Pennsylvania’s $1.07 billion opioid settlement to DDAP. The overall settlement was reached between states’ attorneys general and Johnson & Johnson, AmerisourceBergen, Cardinal Health, and McKesson.

DDAP plans to use the remaining money from this year’s opioid settlement allocation to provide treatment and recovery support services to communities of color; address workforce issues; and fund services in the Kensington area of Philadelphia with a $1 million grant. Read more about the crisis services grants.

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The agenda for the December 7, 2022 Managed Long-Term Services and Supports (MLTSS) Subcommittee meeting was just released by the Office of Long-Term Living (OLTL). The meeting will be held in person (Honors Suite, 1st Floor, 333 Market St, Harrisburg, PA 17126) and via webcast from 10:00 am – 1:00 pm. To receive the information to join the meeting, please register in advance.

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The Centers for Medicare and Medicaid Services (CMS) published the calendar year (CY) 2023 Medicare Physician Fee Schedule (MPFS) in the Federal Register for November 18, 2022. Some of the key provisions contained in the final rule include (and are effective on January 1, 2023):

Medicare Telehealth Services

  • Addition of new HCPCS codes to the list of Medicare telehealth services on a Category 1 basis.
  • Implementation of the 151-day extensions of Medicare telehealth flexibilities, including allowing telehealth services to be provided in any geographic area and in any originating site setting.
  • Permission for physical therapists, occupational therapists, speech-language pathologists, and audiologists to provide telehealth services.
  • Listing of codes added to the telehealth services list are here.

Evaluation & Management (E&M) Visits

  • For CY 2023, CMS finalized changes for “Other E/M” visits that parallel the changes that were made in recent years for office/outpatient E/M visit coding and payment. Other E/M visits include hospital inpatient, hospital observation, emergency department, nursing facility, home services, residence services, and cognitive impairment assessment visits.

Behavioral Health

  • Proposal finalized to create a new HCPCS code (G0323) describing General Behavioral Health Integration performed by clinical psychologists or clinical social workers to account for monthly care integration where the mental health services provided are serving as the focal point of care integration.

Chronic Pain Management

  • Finalized a CY 2023 proposal to create two new G codes (G3002 and G3003) performed by physicians and other qualified health professionals describing monthly CPM for payment starting January 1, 2023.

Opioid Treatment Programs (OTPs)

  • CMS finalized the proposal to allow the OTP intake add-on code provided via 2-way, interactive, audio-video technology when billing for the initiation of treatment with buprenorphine using audio-video technology to start treatment with buprenorphine as authorized by the Drug Enforcement Administration (DEA) and Substance Abuse and Mental Health Services Administration (SAMHSA) at the time the service is provided.
  • CMS also finalized the proposal to permit the use of 2-way, interactive, audio-only technology to start treatment with buprenorphine in cases where audio-video technology isn’t available to the patient and all other applicable requirements are met.

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Last week Senator Bob Casey became a cosponsor on the Latonya Reeves Freedom Act (S.3417). This legislation would create a right to live in the community with related support for Home and Community-Based Services (HCBS) provisions. The Latonya Reeves Freedom Act of 2021/22 also has housing rights, including an accessible housing provision for people with disabilities to live in the community.

Here is a related press release summarizing the legislation from the lead sponsor of S.3417 from Senator Michael Bennett (D-CO).

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