';
Featured
Featured posts

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:

  • Providers who previously received, rejected or accepted a General Distribution Provider Relief Fund payment. Providers that have already received payments of approximately 2% of annual revenue from patient care may submit more information to become eligible for an additional payment.
  • Behavioral Health providers, including those that previously received funding and new providers.
  • Healthcare providers that began practicing January 1, 2020 through March 31, 2020. This includes Medicare, Medicaid, CHIP, dentists, assisted living facilities and behavioral health providers.

Payment Methodology – Apply Early

All eligible providers will be considered for payment against the below criteria.

  1. All provider submissions will be reviewed to confirm they have received a Provider Relief Fund payment equal to approximately 2 percent of patient care revenue from prior general distributions. Applicants that have not yet received Relief Fund payments of 2 percent of patient revenue will receive a payment that, when combined with prior payments (if any), equals 2 percent of patient care revenue.
  2. With the remaining balance of the $20 billion budget, HRSA will then calculate an equitable add-on payment that considers the following:
    • A provider’s change in operating revenues from patient care
    • A provider’s change in operating expenses from patient care, including expenses incurred related to coronavirus
    • Payments already received through prior Provider Relief Fund distributions.

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.
——————————
Shannon McCracken
Vice President of Government Relations
ANCOR
606.271.3555
[email protected]
——————————

0 1015

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:

  • Comprehensive machine-readable file with all items and services
  • Display of shoppable services in a consumer-friendly format

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:

  1. CPS facility units may be re-allocated among CPS Facility, CPS Community, In-Home and Community Supports, Companion and/or Respite services.
  2. The cap exception is needed because of any other change in service as a result of the COVID-19 pandemic.
  3. All cap exception changes must include documentation of why the impact of COVID-19 resulted in the need for the cap exception.
  4. The federal approval to grant COVID-19 related cap exceptions currently expires on March 10, 2021, so absent a further extension, FY 2021-22 individual plans must be within established caps for the P/FDS and Community Living waivers. In preparation for the expiration of the COVID-19 related cap exceptions, teams should meet prior to March of 2021 to discuss plan changes that will be necessary to ensure that FY 2021-22 plans are within established caps for P/FDS and Community Living Waiver.

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.

Governor Wolf signed Act 24 of 2020, which allocates funding from the federal Coronavirus Aid, Relief, and Economic Security Act – also known as the CARES Act – to assist providers with COVID-19 related costs. Funding from Act 24 must be used to cover necessary COVID-19 related costs incurred between March 1, 2020 and November 30, 2020 that have not been otherwise reimbursed by Federal, State or other source of funding. To qualify for the one-time payment, a person or entity must have been in operation as of March 31, 2020. Under Act 24, $259.28 million of COVID-19 relief funds were allocated to providers of Intellectual Disabilities – Community Waiver program.

Any person or entity accepting a COVID-19 payment must provide documentation to the Department of Human Services (DHS), upon request, for purposes of determining compliance with Act 24 requirements. Providers were previously advised to keep documentation to demonstrate how the funds were used for a response to the COVID-19 pandemic in case of an audit.

DHS has developed the attached reporting forms to collect information about the use of Act 24 funding. The reporting form captures provider information; COVID-19 related staffing, expenditures and revenue losses; and COVID-19 related revenue to determine the net impact. Providers are advised to review guidance for eligible COVID-19 costs on the U.S. Department of Treasury website: Coronavirus-Relief-Fund-Guidance and  Coronavirus-Relief-Fund-Frequently-Asked-Questions and DHS guidance DHS Frequently Asked Questions.

DHS is requesting the following two reports from providers:

An interim report which identifies the total COVID-19 related costs each provider projects to incur by November 30, 2020. This interim report is due by October 20, 2020. To assist providers in projecting eligible costs, DHS recommends using the cost report attached and reporting costs that appear in cells H92 and H125. Provider must report the projected costs through a web-based portal.

Providers are required to complete a final cost report and upload it through the web-based portal by no later than December 21, 2020. Providers should keep all documentations related to the costs reported in the final cost report for a minimum of 5 years.

In advance of the report’s due date, DHS recommends providers review the attached cost reporting form and instructions and begin compiling the required information. Information on how to access the web-based reporting portal will be sent through a separate email to each provider.  This information will be provided in advance of the submission due dates noted above.

Thank you for your ongoing assistance during these trying times.  Please submit any questions about ODP Act 24 expense reporting to Rick Smith.

Rick Smith  l  Director

PA Department of Human Services  l  Office of Developmental Programs

Bureau of Financial Management and Program Support

625 Forster Street Room 412  l  Harrisburg, PA  17120

717.783.4873

www.dhs.pa.gov  www.myodp.org

The Office of Developmental Programs’ (ODP) is very interested in better understanding your experience during this pandemic. More specifically, we would like to capture your thoughts and perspectives regarding ODP’s actions during the pandemic, as well as your agency’s response to the pandemic. The purpose of this survey is to have information to guide future decision making during and after the pandemic.

We are asking the providers of the following services to complete this survey:

  1. Intellectual Disability/Autism (ID/A) Waivers and Adult Autism Waiver (AAW): Residential, Employment, Behavioral, Nursing,
  2. ID/A: In Home Community Support and Companion, and
  3. AAW: Community Support and Systematic Skill Building.

Please note that there are other information collection efforts underway to collect the experiences for other service types. Specifically, Community Participation Support providers should not complete this survey.

We have taken much effort to design a survey that ensures the feedback will be useful in making additional decisions during the remainder of and after the pandemic. Therefore, you will note that this is a rather robust survey. While piloting the survey with providers, we noted that it took an average of 60-90 minutes to complete. This was dependent on the service type chosen as that determines how many questions are asked of the respondents.

We are asking that you complete one survey for each service you provide as an agency but understand that this may be burdensome. If you cannot dedicate staff to completing for each service you provide, please complete for at least the top two or three services by volume that you provide. For large providers that cover a broad geographic area we encourage you to complete surveys that will represent the diversity of experience your organization may have experienced since the pandemic began.

Generally, the feedback should represent the agency’s opinions. To support this, we have developed a document capturing all survey questions that you can review prior to completing the survey in QuestionPro (see attached). We would very much appreciate if you would find the time to complete this survey, at least once, so that your perspectives are included.

You can access the survey here: https://afteraction2020.questionpro.com

The survey will be open until Friday, October 9, 2020.

Kristin Ahrens
Deputy Secretary
PA Department of Human Services | Office of Developmental Programs

The Pennsylvania Family Support Alliance has created a resource with helpful tips on how to recognize abuse and/or neglect when interacting with children virtually as well as other helpful information and resources. For any questions regarding this resource or mandated reporter training, visit their website at www.pa-fsa.org.

If you have further questions, please contact RCPA Children’s Director Jim Sharp.

The Centers for Medicare and Medicaid Services (CMS) recently announced that the inpatient rehabilitation facility (IRF) provider preview reports have been updated on the iQIES site and are now available for Quarter 1 of 2019 through Quarter 4 of 2019 data and the annual update of the claims-based measures data from Quarter 4 of 2017 through Quarter 3 of 2019. The information contained within the preview reports contains the data that will be published on IRF Compare during the December 2020 refresh of the website. The December 2020 refresh is the rescheduled IRF Compare refresh that was initially scheduled for September 2020.

The deadline for providers to review their data is October 26, 2020. Corrections to the underlying data will not be permitted during this timeframe; however, providers can request CMS to review the data during this preview period if they believe the quality measure scores that are displayed in their reports are inaccurate. Six new measures will be displayed publicly beginning with the December 2020 refresh and will be removing one quality measure (Percent of Residents or Patients With Pressure Ulcers that are New or Worsened) from the IRF Compare and Care Compare websites. The six new measures include:

  • Changes in Skin Integrity Post-Acute Care (PAC): Pressure Ulcer/Injury,
  • Drug Regimen Review Conducted with Follow-Up for Identified Issues – PAC IRF QRP,
  • IRF Functional Outcome Measure: Change in Self-Care Score for Medical Rehabilitation Patients (NQF #2633),
  • IRF Functional Outcome Measure: Change in Mobility for Medical Rehabilitation Patients (NQF #2634),
  • IRF Functional Outcome Measure: Discharge Self-Care Score for Medical Rehabilitation Patients (NQF #2635), and
  • IRF Functional Outcome Measure: Discharge Mobility Score for Medical Rehabilitation Patients (NQF #2636)