The Government Affairs call scheduled for Thursday, October 15 has been cancelled. Updates will be discussed in the Member Update Webinar scheduled for Wednesday, October 14, 2020 at 2:00 pm. To attend the Member Update, please register here.
CMS is hosting a training to provide states with monitoring strategies to ensure compliance with the HCBS Settings Rule. States are required to submit a Statewide Transition Plan (STP) to CMS to ensure their HCBS programs meet the criteria of the HCBS Setting Rule by March 17, 2023.
This training will:
This training will be held on Tuesday, October 14 from 1:30 PM to 3:00 PM ET.
Click here to register for this training.
FOR IMMEDIATE RELEASE
October 2, 2020
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Harrisburg, PA – Amid the pandemic, rising health care costs and magnified health inequities, Governor Tom Wolf today unveiled a plan that addresses comprehensive health reforms focusing on both physical and behavioral health and promoting affordability, accessibility and value in health care.
“I am proposing a health reform package that will make health care more affordable, hold health care corporations accountable and tackle the health inequities resulting from systemic racism,” Gov. Wolf said. “True reform means focusing on every aspect of a person that contributes to their health. Even before the pandemic, there were warning signs that Pennsylvania’s health care system wasn’t working for everyone. Many Pennsylvanians found it hard to pay their medical bills due to rising health care costs, including families who have health care coverage and often have to pay higher premiums and more out-of-pocket costs every year.”
Health care access has historically been more difficult for many, and because of the pandemic, affordability is expected to become a crisis, with more than 1.5 million Pennsylvanians expected to become uninsured.
COVID-19 has also worsened the pre-existing inequities that some disadvantaged neighborhoods face, disproportionately hurting Pennsylvanians of color.
Chief Innovation Officer at the Department of Human Services, Dr. Doug Jacobs, outlined the components of the health reform plan and how they will address these issues.
“As a board-certified and practicing internal medicine physician, I see first-hand how affordability and a whole-person approach to care is so crucial to helping Pennsylvanians access the health care they deserve,” Dr. Jacobs said. “Governor Wolf is proposing a whole-person health reform package that will make comprehensive, quality health care more affordable and accessible.”
The three main components of the plan include:
Gov. Wolf and Dr. Jacobs were joined at the announcement by Pennsylvania Health Access Network director Antoinette Kraus, home health care aide Hillary Rothrock, and Little Amps owner Peter Leonard.
“Far too many Pennsylvanians put off care or skip tests and treatment because of what’s in their wallets rather than what’s best for their health,” Antoinette Kraus said. “Without reforms that directly address high and rising healthcare costs, families will continue to struggle with getting the care they need without facing financial ruin, and health disparities will also widen. We applaud Governor Wolf for addressing these issues by introducing reforms that will increase transparency, improve health equity, and lower costs.”
“Little Amps has long been striving to find a way to provide high quality health care coverage to our team – my peers in the small business community know just how difficult this can be despite how essential it is to our collective wellbeing,” Peter Leonard said. “It simply is not affordable, and that is unacceptable. We support Governor Wolf’s Whole-Person Health Reform proposal because of its ability to decrease costs and make healthcare more affordable for small businesses like ours.”
“I’m grateful to Governor Wolf for introducing the Whole-Person Health Reform initiative,” Hillary Rothrock said. “So many of us in health care want desperately to provide everything we can for our consumers, but we aren’t given the resources we need. Finding cost savings that can be redirected toward direct care is critically needed.”
“The COVID-19 pandemic has exacerbated many of the challenges that our commonwealth faced prior to this year,” Gov. Wolf said. “We are more aware now of how precarious many systems we all took for granted are, and how the inequities that exist in those systems harm some of our most vulnerable Pennsylvanians. We need to take these actions now to make sure that health care is affordable and accessible for every Pennsylvanian, and to guarantee that the care Pennsylvanians receive is valuable and of high quality.”
MEDIA CONTACT: Lyndsay Kensinger, ra-gvgovpress@pa.gov
RCPA’s IDD Committee will be meeting on October 15, 2020 from 12:00 pm until 3:00 pm. We are fortunate to have a panel of guest speakers confirmed from the Office of Developmental Programs (ODP). Julie Mochon, Director Division of Policy, Ashley Senoski, Grants and Fiscal Manager Bureau of Financial Management and Support, Alisa Hendrickson and Nora Campanella from the Regulatory Administration will be joining the meeting to address topics that we have specifically asked to discuss.
We have given them a list of issues we have recently heard from our members. If you have questions that you would like for us to submit, please send those to Carol Ferenz by the close of business on Wednesday, October 6, 2020. This will allow time for our guest speakers to prepare for our meeting.
If you have not yet registered for the IDD Committee meeting, you can do so here. We are looking forward to a productive discussion with ODP and appreciate the time they have committed to us on the 15th.
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:
The E&C website contains the videos from the hearing. The key takeaways from the hearing include:
From ANCOR:
Big news from HHS….and welcome news, considering the uncertain future of the 4th package negotiations between the House, the Senate and the Administration. See the highlighted sections below, but at first read, our members are eligible. (Note: the Medicaid only tranche was considered part of the Phase 2 General Distribution).
We will continue to dig into the details and also analyzing the reporting requirements that came out recently!
Statement from HHS:
Today, under the leadership of President Trump, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), is announcing $20 billion in new funding for providers on the frontlines of the coronavirus pandemic. Under this Phase 3 General Distribution allocation, providers that have already received Provider Relief Fund payments will be invited to apply for additional funding that considers financial losses and changes in operating expenses caused by the coronavirus. Previously ineligible providers, such as those who began practicing in 2020 will also be invited to apply, and an expanded group of behavioral health providers confronting the emergence of increased mental health and substance use issues exacerbated by the pandemic will also be eligible for relief payments.
Providers can begin applying for funds on Monday, October 5, 2020.
“HHS has worked to ensure that all American healthcare providers receive support from the Provider Relief Fund in a fast and fair way, and this new round helps ensure that we are reaching America’s essential behavioral health providers and takes into account losses and expenses relating to coronavirus,” said HHS Secretary Alex Azar. “We’ve worked with all of the resources we have across HHS to ensure that America’s heroic healthcare providers know they can apply for support.”
HHS has already issued over $100 billion in relief funding to providers through prior distributions. Still, HHS recognizes that many providers continue to struggle financially from COVID-19’s impact. For eligible providers, the new Phase 3 General Distribution is designed to balance an equitable payment of 2 percent of annual revenue from patient care for all applicants plus an add-on payment to account for revenue losses and expenses attributable to COVID-19.
Further, HHS recognizes constraints such as the stay-at-home orders and social isolation have been particularly difficult for many Americans. A recent Centers for Disease Control and Prevention (CDC) report found the prevalence of symptoms of anxiety disorder in the second quarter of 2020 was approximately three times those that reported in the second quarter of 2019 (25.5% versus 8.1%); and the prevalence of depressive disorder was approximately four times that reported in the second quarter of 2019 (24.3% versus 6.5%). Our behavioral health providers have shouldered the burden of responding and confronting this expanded challenge triggered by the pandemic. When traditional face-to-face counseling was restricted and new telehealth flexibilities were put in place in response to the pandemic, many behavioral health providers invested in and adopted – PDF telehealth technologies to continue providing patient care. While some Medicare or Medicaid behavioral health providers have already received prior General Distribution payments, others have not. Working with the Substance Abuse and Mental Health Services Administration (SAMHSA), HRSA developed a list of the nation’s behavioral health providers now eligible for funding, which includes, for example, addiction counseling centers, mental health counselors, and psychiatrists.
Eligibility
HHS is making a large number of providers eligible for Phase 3 General Distribution funding, including:
Payment Methodology – Apply Early
All eligible providers will be considered for payment against the below criteria.
We know providers want to receive payments shortly after submitting their information. However, this distribution requires cooperation on the part of all applicants. Again, HHS is urging all eligible providers to apply early; do not wait until the last day or week of the application period. Applying early will help to expedite HHS’s review process and payment calculations, and ultimately accelerate the distribution of all payments.
All payment recipients will be required to attest to receiving the Phase 3 General Distribution payment and accept the associated Terms and Conditions.
Application Deadline
Providers will have from October 5, 2020 through November 6, 2020 to apply for Phase 3 General Distribution funding. HHS’s top priority is ensuring as many providers possible have an opportunity to apply. HHS will continue to host webinars to assist providers through the application process and the call center is also available to address questions.
HHS recognizes the multifaceted challenges of this pandemic cannot be won without frontline healthcare providers focused on containing the virus and delivering holistic care. Funding for this Phase 3 General Distribution was made possible through the bipartisan CARES Act and the Paycheck Protection Program and Health Care Enhancement Act, which allocated $175 billion in relief funds to hospitals and other healthcare providers.
For updates and to learn more about the Provider Relief Program.
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Shannon McCracken
Vice President of Government Relations
ANCOR
606.271.3555
smccracken@ancor.org
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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:
CMS has developed the following resources for providers to utilize to prepare and ensure they are compliant:
ODP has updated Announcement 20-069 to provide guidance to Individual Support Planning Teams on the criteria for requesting a cap exception for the Person/Family Directed Support (P/FDS) and Community Living Waivers. (Updates appear in the document in red).
ODP will continue allowing additional P/FDS and Community Living Waiver cap exceptions consistent with the following guidance:
In order to request a FY 20-21 cap exception as a result of the COVID-19 pandemic, please complete the attached template and submit to your Regional Waiver Capacity Manager.
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