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The next phase of the Centers for Medicare and Medicaid Services (CMS) inpatient rehabilitation facility (IRF) review choice demonstration (RCD) is scheduled to be implemented in Pennsylvania on June 17, 2024, and will last for five years. This demonstration applies to only IRF providers physically located in Pennsylvania.
Between May 3, 2024, and June 2, 2024, IRFs must select either 100% pre-claim review or 100% post-payment claim review.
CMS has stated that creating a review choice process will ensure Medicare coverage and documentation requirements are likely met. This program reduces the number of Medicare appeals, improves provider compliance with Medicare program rules, does not alter the Medicare IRF benefit, and should not delay medically necessary care to Medicare beneficiaries.
Novitas Solutions is the Medicare Administrative Contractor (MAC) for Pennsylvania and will process the IRF claims. In preparation for the implementation of IRF RCD, Novitas Solutions will be conducting their first webinar on April 24, 2024, from 1:00 pm – 2:30 pm. Registration to participate in this webinar is now open. Members are strongly encouraged to participate in this webinar to prepare for this demonstration. If the registration link does not work, please copy and paste the below link into your browser to register:
https://fcso.webex.com/webappng/sites/fcso/meeting/register/0fd87e2111f7446fa477d0a25f78674c?ticket=4832534b000000073a942d9e6f94601b6b106adc8f502bcee359653432e8c326edb0f50ebc253329×tamp=1711559626291&RGID=re6663754d2fe70defe3195e29c69465a
In addition to information on the CMS website, Novitas Solutions has a dedicated website that provides a great deal of information and resources on IRF RCD.
The Office of Developmental Programs (ODP) is pleased to offer a webinar regarding the Specialty Telehealth and Assessment Team (STAT) waiver service. STAT is a new waiver service available to individuals in the Person/Family Directed Support (P/FDS), Community Living, and Consolidated Waiver programs. STAT is a telehealth service that is consultative and provides disability-specific advice on when best to seek additional or in-person medical treatment for the participant. It provides 24/7 access to physicians with extensive education and experience within the IDA population 365 days a year, who triage and evaluate medical conditions as needed. This webinar will provide an in-depth look at the STAT waiver service, how it works, and the benefit to participants.
ODP Will be holding two sessions. The information will be the same at both. Pre-registration is required. Select the preferred session date to register.
The Office of Developmental Programs (ODP) has shared this important announcement from FEMA and the Rosalynn Carter Institute for Caregivers (RCI).
In recognition of caregivers’ dedication and commitment to those in their care, the Federal Emergency Management Agency (FEMA) and the Rosalynn Carter Institute for Caregivers (RCI) have created the Disaster Preparedness Guide for Caregivers to help them navigate unique challenges that may arise during disasters.
When forced to evacuate, relocate to emergency shelters, or find temporary housing, care recipients and caregivers require support and services that meet them where they are and account for unmet needs. FEMA is pleased to announce this new guide that focuses on the lived experience of caregivers who often serve as a lifeline for others, whether the skies are blue or gray.
See the new guide for the three essential steps that can help caregivers feel more prepared and in control when disaster strikes.
President Biden signed the Further Consolidated Appropriations Act, 2024 into law on March 23. This Act includes the Labor, Health and Human Services, Education, and Related Agencies Appropriations Act, 2024. Notable FY 2024 funding totals for mental health and substance use include:
Additionally, key provisions of the Act include an $18 million increase in funding for the 988 Suicide & Crisis Lifeline and a $1 million increase for the Primary and Behavioral Health Care Integration grant technical assistance program. There is also a $75 million increase for mental health research conducted by the National Institute of Mental Health. Various mental health and substance use programs maintained funding levels similar to those of FY 2023. For more information, you can access the full explanatory text as well as the comparative highlights table.
If you have any questions, please contact RCPA Policy Director Jim Sharp.
The Office of Developmental Programs (ODP) has shared ODPANN 24-031, which informs all interested stakeholders of the submission of the Consolidated, Community Living, Person/Family Directed Support (P/FDS), and Adult Autism Waiver (AAW) amendments that contain Workforce Recovery Supplemental Payments to CMS and provides guidance for requesting these payments. The submitted waiver amendments are available on the Department of Human Services website.
Please view the announcement for information and details, and note that providers are required to complete ODP’s survey to request these payments.
The Office of Developmental Programs (ODP) has shared ODPANN 24-032. The purpose of this announcement is to communicate that the Administrative Review (AR) Course, which includes an online module and a live virtual case study session, is now available. All entities that complete investigations are required to conduct the AR process, as outlined in the AR Manual. This course is offered as an opportunity to support entities to complete high-quality ARs that help mitigate risks to individuals receiving services. Please view the announcement for information and details.