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We are pleased to announce the Medicaid Management Information System (MMIS) 2020 Platform Project website is now live! The direct link to the MMIS 2020 homepage is: https://www.dhs.pa.gov/MMIS/Pages/default.aspx.

You may have also noticed the previous MMIS 2020 webpage link, located within the Providers > Sort by Industry section of the Department of Human Services (DHS) website, now appears as “*New* MMIS 2020.” This link will now take you to the new MMIS 2020 website.

What’s New?

Within the new MMIS 2020 website, you will find the following pages which contain topic-specific information related to the project:

  • About MMIS – Overview of the MMIS 2020 Platform Project
  • Our Team – Information about the MMIS 2020 employees and contractors, such as the Information Technology Consulting/Quality Assurance (ITC/QA), System Integrator/Data Hub (SI/DH), and Electronic Data Interchange (EDI) contractors
  • Key Dates – MMIS 2020 Procurement Dates
  • News – Recent MMIS 2020 Platform news and events, such as Release A updates
  • Development – Information detailing the process of developing a replacement MMIS
  • Managing Change – Information on Organization Change Management
  • MMIS FAQ – Frequently Asked Questions about the MMIS 2020 Platform Project
  • Contact MMIS – Contact information for general MMIS questions/inquiries, procurement questions, and website/technical issues

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The IOP/PHP Rollout Sessions have been rescheduled for the first week of November. Providers should see the schedule (also found on our website) for specific dates, times, links, and call-in details to join the meeting. Participants are highly encouraged to engage in the webinar by Skype rather than by phone in order to access the video portion of the presentation. Detailed information will be shared by video that will be advantageous to participants.

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DDAP Logo Website

Human Trafficking
Wednesday, October 14 from 10:30 am – 12:30 pm

Objectives:

  • Identify the signs that a client has been trafficked and determine a proper treatment plan
  • Create the appropriate therapeutic environment to enable the best clinical outcomes for a trafficking survivor
  • Differentiate among the various types of trafficking, including: sex trafficking, labor trafficking, child soldiers and organ donation to better inform clinical assessment and treatment interventions

Family Therapy in Addiction
Thursday, October 15 from 11 am – 12 pm

Objectives:

  • To understand why family members who have a loved one with addiction need to find support for themselves first
  • To learn how family members can connect to support for themselves
  • To provide a different perspective of addiction from the lens of a family member who has a loved one struggling with addiction

Tobacco & Nicotine Treatment Options
Thursday, October 22 from 10 am – 11 pm

Course Goals:

  • Understand the health risks related to tobacco/nicotine use through the lens of substance use disorder & behavioral health
  • Understand tobacco/nicotine recovery treatment options, billing and coding
  • Reduce health and cost burdens for substance use disorder providers and patients
  • Foster a culture of tobacco/nicotine treatment in the substance use recovery community
  • Cultivate tobacco/nicotine treatment professionals and champions

Understanding the family disease of addiction
Tuesday, October 27 from 11 am – 12 pm

Participants will be able to:

  • Explain the impact of substance abuse on a family system
  • Identify survival roles in the family and their function
  • Identify survival rules in the family and their impact on the family
  • Explain family triggers
  • Explain PAWS and impact on recovery

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During the October 7, 2020 MLTSS Subcommittee meeting, representatives from AmeriHealth Caritas shared information about provider education webinars planned during the month of October. The webinars are open to Home-and-Community-Based Services providers and will be conducted via Zoom on the dates below:

  • Tuesday, October 20, 2020, 10:00 am – 12:00 pm session, please register here
  • Thursday, October 22, 2020, 1:00 pm – 3:00 pm session, please register here

Advance registration is required. After registering for a session, a confirmation email will be sent that will contain information about joining the Zoom webinar.

Some of the topics that will covered include:

  • Critical incident reporting;
  • Missed visits process;
  • Claims/billing/timely filing;
  • Cultural competency;
  • And more

If there are questions about these webinars, please contact your provider Account Executive. You can locate your Account Executive information on the AmeriHealth Caritas website.

Please send your questions, comments, and feedback to this email.

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Today, the Office of Long-Term Living’s (OLTL) Bureau of Human Licensing (BHSL) sent the following notice to providers regarding the resumption of annual on-site inspections.

Per the attached Resumption of Annual Inspections During the COVID-19 Pandemic, The Office of Long-Term Living’s Bureau of Human Licensing (BHSL) has resumed annual renewal on-site inspections effective October 5, 2020.

In accordance with CDC guidance, and the Order of the Secretary of the Pennsylvania Department of Health Directing Long-Term Care Facilities to Implement Measures for Use and Distribution of Personal Protective Equipment, BHSL Licensing Representatives will be reviewing the following practices during their on-site inspections and may cite a violation if warranted:

Universal Masking

  1. Staff, including Direct Care Staff, must always wear a facemask while they are in the facility.
  2. PCH and ALR staff must also wear facemask outside where staff are unable to maintain the 6-foot social distance.
  3. Implement universal masking for everyone entering a facility (e.g., direct care staff, residents, visitors), regardless of symptoms.
  4. Residents may remove their cloth face covering/facemask when in their rooms but should put them back on when leaving their room or when others (e.g., staff, visitors) enter the room.
  5. The availability of respirator masks and ability to arrange fit-testing in the event that a resident tests positive within the facility.

Screening

  1. Screen residents and staff for fever and respiratory symptoms (using a checklist for employees such as the one developed by the American Health Care Association and the National Center for Assisted Living or as described by the CDC.
  2. Staff should be screened at the beginning of every shift. Test staff who screen positive.
  3. Residents should be screened at least daily and test any resident who exhibits fever or symptoms consistent with COVID-19.
  4. Actively screen everyone for fever and symptoms of COVID-19 before they enter the facility.

Reporting

  1. The COVID-19 Data Collection Tool is utilized to report positive test results for staff and residents, and deaths related to COVID-19 for cases identified 8/28/20 or later.
    COVID-19 Data Collection Tool User Guide
  1. The COVID-19 Tracker tool is submitted for all positive results received for staff or residents, and deaths related to COVID-19 prior to 8/28/20.
    Facility COVID-19 Tracker

If you have any questions, please contact your regional office.

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HRSA

Dear Stakeholder,

Thank you for your interest in the Provider Relief Fund as administered by the US Dept. of Health and Human Services (HHS) via the Health Resources and Services Administration (HRSA). As you may be aware, HHS recently made $20 billion in new funding available for a Phase 3 General Distribution allocation, and the Provider Relief Fund would like your help to reach as many providers as possible.   More information about this distribution can be found in our press release, and by registering for our webcast on October 15 at 3 p.m. ET.

We have created a stakeholder toolkit so interested parties can easily share this funding opportunity with their networks nationwide. In this toolkit, you will find newsletter and email content, social media posts and images, information about next week’s webinar, and also helpful resources for applicants.

For more information, visit the following website: https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/general-information/stakeholder-toolkit/index.html.

Thank you for sharing,
Provider Relief Fund Team

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New recoupment terms allow providers and suppliers one additional year to start loan payments.

CMS announced amended terms for payments issued under the Accelerated and Advance Payment (AAP) Program as required by recent action by President Trump and Congress. This Medicare loan program allows CMS to make advance payments to providers, which are typically used in emergency situations. Under the Continuing Appropriations Act, 2021 and Other Extensions Act, repayment will now begin one year from the issuance date of each provider or supplier’s accelerated or advance payment. CMS issued $106 billion in payments to providers and suppliers in order to alleviate the financial burden health care providers faced while experiencing cash flow issues in the early stages of combating the Coronavirus Disease 2019 (COVID-19) public health emergency.

“In the throes of an unprecedented pandemic, providers and suppliers on the frontlines needed a lifeline to help keep them afloat,” said CMS Administrator Seema Verma. “CMS’ advanced payments were loans given to providers and suppliers to avoid having to close their doors and potentially causing a disruption in service for seniors. While we are seeing patients return to hospitals and doctors providing care we are not yet back to normal,” she added.

CMS expanded the AAP Program on March 28, 2020, and gave these loans to health care providers and suppliers in order to combat the financial burden of the pandemic. CMS successfully paid more than 22,000 Part A providers, totaling more than $98 billion in accelerated payments. This included payments to Part A providers for Part B items and services they furnished. In addition, more than 28,000 Part B suppliers, including doctors, non-physician practitioners, and durable medical equipment suppliers received advance payments totaling more than $8.5 billion.

Providers were required to make payments starting in August of this year, but with this action, repayment will be delayed until one year after payment was issued. After that first year, Medicare will automatically recoup 25% of Medicare payments otherwise owed to the provider or supplier for 11 months. At the end of the 11-month period, recoupment will increase to 50% for another 6 months. If the provider or supplier is unable to repay the total amount of the AAP during this time-period (a total of 29 months), CMS will issue letters requiring repayment of any outstanding balance, subject to an interest rate of 4%.

The letter also provides guidance on how to request an Extended Repayment Schedule (ERS) for providers and suppliers who are experiencing financial hardships. An ERS is a debt installment payment plan that allows a provider or supplier to pay debts over the course of 3 years, or, up to 5 years in the case of extreme hardship. Providers and suppliers are encouraged to contact their MAC for information on how to request an ERS. To allow even more flexibility in paying back the loans, the $175 billion issued in Provider Relief funds can be used towards repayment of these Medicare loans. CMS will be communicating with each provider and supplier in the coming weeks as to the repayment terms and amounts owed as applicable for any accelerated or advance payment issued.

For More Information:

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FOR IMMEDIATE RELEASE
October 8, 2020

Harrisburg, PA – Department of Human Services (DHS) Secretary Teresa Miller today discussed the measures Pennsylvania is taking to protect individuals with autism, intellectual and physical disabilities and older Pennsylvanians as the COVID-19 crisis continues. She also urged Pennsylvanians to continue to diligently follow public-health guidance in order to protect vulnerable Pennsylvanians who may be more at risk of complications if they develop COVID-19.

“We know that COVID-19 is an especially serious threat and can jeopardize the health of individuals with disabilities, so protecting our most vulnerable neighbors is a collective effort,” said Secretary Miller. “DHS has been doing everything in our power to ensure that the supports that we provide continue uninterrupted. But as we begin to enter winter and flu season alongside an ever-changing public health crisis, I want to reiterate that our continued success in the fight against COVID-19 relies on each of us doing all we can, such as wearing a mask and practicing social distancing, to protect those we know and those we don’t.”

Samantha Dorm, a York County mother whose 19-year-old son Michael Graff is recovering from COVID-19, echoed Secretary Miller’s call for the public to consider the effect their actions can have on vulnerable individuals. Michael has Down syndrome and autism.

“Protecting vulnerable people like my son is a responsibility that each of us carries. If nothing else, the COVID-19 crisis has made it clear that we are all truly connected and dependent on one another. But when people are unwilling to be flexible and make inconvenient changes to their lives – like wearing a mask at the grocery store or avoiding large gatherings – it can cost lives, though it may not be their own,” Dorm said. “The only way we can mitigate the long-term impact of the virus on people with intellectual and developmental disabilities is to embrace the concept of shared responsibility and coordinated action. We are all in this together.”

DHS administers Pennsylvania’s Medicaid program, which helps more than 3 million Pennsylvanians access health care. About 17 percent – or roughly 480,000 people – are individuals with disabilities. These Pennsylvanians access health care and other assistive services primarily through DHS’ Office of Developmental Programs (ODP) and the Office of Long-Term Living (OLTL).

Office of Developmental Programs

ODP supports more than 56,000 individuals with an intellectual disability, developmental disability, or autism — a population that is particularly high risk for contracting COVID-19. ODP is responsible for regulating more than 7,500 licensed settings across the commonwealth.

ODP has adjusted policies to ensure continuity of services during the health crisis and has received flexibilities from the Center for Medicare and Medicaid Services (CMS) to allow for:

  • Expanding services that relatives can provide,
  • Expanding services that can be offered remotely, and
  • Expanded settings where services can be provided to ensure adequate quarantine and isolation space when needed.

DHS has also worked with the Pennsylvania Department of Aging to develop and provide extensive guidance and technical assistance to our providers of community participation supports or ‘day programs’ in order to re-open these facilities. This has allowed for thousands of people to return to services during the day and provides them with enriching activities aimed at promoting health and wellness.

Office of Long-Term Living

OLTL supports individuals with physical disabilities and older adults many who are dually eligible for Medicare and Medicaid with their long-term care needs. This includes more than 371,000 Pennsylvanians who receive long-term services and supports through the Community HealthChoices program and more than 65,000 Pennsylvanians who live in more than 1,200 personal care homes and assisted living residences regulated and licensed by OLTL.

OLTL has ensured that no participant is to be disenrolled from Medicaid, even if they have not completed their eligibility redetermination application. OLTL continues to work with managed care organizations (MCOs) to ensure all necessary services are in place.

It has also received flexibilities from CMS to allow for:

  • Personal protective equipment to be added to a person’s service plan,
  • Services such as counseling or cognitive rehabilitation therapy to be provided virtually, and
  • MCOs to assess clients either telephonically or in person.

OLTL has also adhered to the Department of Aging’s reopening guidance for adult day care centers and the LIFE program. As adult day service providers begin to reopen in parts of the state, participants are given the choice to attend these programs or receive services in their homes.

As flu season approaches, DHS is reminding all Pennsylvanians to get flu shots, especially given the additional risk of COVID-19. DHS will continue to follow guidance coming from the Centers for Disease Control and Prevention (CDC) and the Pennsylvania Department of Health to ensure the continuity of care and protections for the communities it serves.

Secretary Miller acknowledged October as National Disability Employment Awareness Month (NDEAM), which reinforces the value and talent that people with disabilities add to workplaces and communities and affirms Pennsylvania’s commitment to being an inclusive community. Pennsylvanians with disabilities who are interested in employment should connect with the Department of Labor & Industry’s Office of Vocational Rehabilitation or visit ODP’s www.myodp.org and click “Resources” and select “Employment” for various resources. DHS’ employment services are still available to assist people who are working or seeking work, and many of these services can be provided remotely.

“As the economy recovers, it is absolutely critical to ensure that people with disabilities are able take part in that recovery. Workplaces should examine their policies to see which ones are outdated or intentionally or unintentionally excluding individuals with disabilities. They should also actively develop and promote specific employment opportunities for people with disabilities,” said Secretary Miller.

For more information visit www.dhs.pa.gov.

MEDIA CONTACT: Erin James, [email protected]

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Message from Kevin Dressler

Election/ Voting

The deadline to register and also submit for mail in ballots for the upcoming general election is rapidly coming upon us. I wanted to send out the link to the Voting in PA website for any information you need to assist the people you support to be prepared to vote in the upcoming election, if they desire to do so. The deadline to register to vote is October 19 and this can be completed online. Mail in ballots need to be received at the respective election district by 5pm on October 27. The applications for voter registration and the mail in ballot application can be found at the following link: www.votespa.com. I have also included CMS guidance surrounding voting that was issued to nursing homes on this topic as a reference. I not aware of any specific guidance from CMS issued to the ICFs at this time on this subject. Please make every effort to support the people we serve in voting if they desire to do so in the general election on November 3.

CLIA Waiver

The ODP Regional ICF leads are going to be reaching out to determine which ICFs have a CLIA waiver to provide on site testing and what can be tested under the approved waiver. Please respond promptly to their request.

Secretary of Health Order on PPE

Please see the Frequently Asked Questions regarding the Department of Health Secretary’s Order Directing Long-Term Care Facilities to Implement Measures for Use and Distribution of Personal Protective Equipment.

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