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The Office of Long-Term Living (OLTL) has announced they will be hosting Transportation Summit 3 (via Zoom) on September 17, 2024, from 9:00 am – 12:00 pm.

The Transportation Summit is an open forum for anyone interested in discussing transportation-related issues in the Community HealthChoices (CHC) Program. There will be staff from various programs on the call, including the managed care organizations (MCO) and transportation brokers, Medical Assistance Transportation Program (MATP), and the Pennsylvania Department of Transportation (PennDOT). They will be on the call to listen to feedback and answer questions as they can.

During the webinar, there will be three ways for individuals to ask questions.

  1. You can submit your questions to OLTL in advance by emailing Cortney Alvord.
  2. They can be read during the meeting, where you will use the “Raise Hand” feature during the meeting, be unmuted, and ask your question.
  3. You can type your question into the “Chat” box located on the right side of your screen during the meeting.

To participate in the Transportation Summit, please register using this registration link. After registering, you will receive a confirmation email containing information about joining the meeting.

Insidious Trauma: Context, Impact, and Considerations for Care
Wednesday, September 11, 2024
10:00 am – 1:00 pm
Register Here

This session will introduce the impact of trauma broadly, provide an overview of insidious trauma and its effects, and explore some relevant interpersonal and clinical considerations in supporting those impacted by traumatic stress. Presenters will share their expertise on best and promising practices as well as provide general knowledge. View the announcement for more information.

 

The Office of Developmental Programs (ODP) has announced the annual publication of the Resource Guide for Supporting Deaf, DeafBlind, and Hard of Hearing Individuals. This guide offers resources in one central location for those who support or care for someone who is Deaf, Hard of Hearing, or DeafBlind and receives supports from ODP.

The Resource Guide is available here or on MyODP’s website under Topics > Special Population Services > Deaf Services. For questions, email ODP Deaf Services.

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The Centers for Medicare and Medicaid Services (CMS) released and published the fiscal year (FY) 2025 inpatient rehabilitation facility prospective payment system (IRF PPS) final rule in the August 6, 2024, Federal Register. Some of the key provisions contained in the provider rule are noted below.


Payment Updates

CMS estimates aggregate payments to IRFs will increase by 2.8 percent in FY 2025, compared to the 4.0 percent payment update that CMS finalized for FY 2024. This update is the result of an annual market basket update, reduced by a productivity adjustment, budget neutrality adjustments for changes to CMG weights and labor/wage changes, and adjustments to the outlier case threshold.

As in previous years, CMS will adopt new delineations for the Core-Based Statistical Areas (CBSA) as identified by the Office of Management and Budget (OMB). [Additional and more detailed information on these new CBSAs can be found in OMB Bulletin No. 23-01] These changes will result in certain counties being reclassified from urban to rural and vice-versa, as well as some counties shifting to different CBSAs. As a result, CMS projects that approximately 10 percent of providers will have a higher wage index, but 16 percent will face a decrease in wage index values (primarily for those reclassified as urban, thus losing the rural adjustment). Thus, CMS finalized a transitional “phase-out” policy for those negatively impacted, such that IRFs set to lose their rural adjustment will retain two-thirds of the adjustment in FY 2025, one-third of the adjustment in FY 2026, and fully “lose” the rural adjustment in FY 2027. CMS estimates that 8 IRFs would be reclassified as urban and thus lose the 14.9 percent rural adjustment.

CMS increased the outlier threshold amount from $10,423 for FY 2024 to $12,043 for FY 2025 (slightly lower than the proposed rule’s projection). This change will account for an estimated 0.2 percent decrease to aggregate payments across the IRF PPS in FY 2025.


Quality Reporting Program (QRP) Updates

CMS finalized its proposal to adopt four new items as Standardized Patient Assessment Data Elements (SPADE) under the social determinants of health (SDOH) category beginning with the FY 2028 IRF QRP: one Living Situation item; two Food items; and one Utilities item. CMS notes that these new SPADES are intended to assist IRFs in “better addressing those identified needs with the patient, their caregivers, and community partners during the discharge planning process, if indicated.”

Transportation Item Modification Finalized Beginning with the FY 2028 IRF QRP (October 1, 2026 Implementation)

Consistent with the AHC HRSN Screening Tool, CMS finalized a proposal to modify the A1250. Transportation item currently collected in the IRF–PAI in two ways: (1) revise the look-back period for when the patient experienced lack of reliable transportation; and (2) simplify the response options.

  • A1250. Transportation currently collected in the IRF-PAI asks: “Has lack of transportation kept you from medical appointments, meetings, work, or from getting things needed for daily living?” The response options are: (A) Yes, it has kept me from medical appointments or from getting my medications; (B) Yes, it has kept me from non-medical meetings, appointments, work, or from getting things that I need; (C) No; (X) Patient unable to respond; and (Y) Patient declines to respond.
  • The finalized Transportation item asks, “In the past 12 months, has a lack of reliable transportation kept you from medical appointments, meetings, work or from getting things needed for daily living?” The final response options are: (0) Yes; (1) No; (7) Patient declines to respond; and (8) Patient unable to respond.

Finalized Proposal to Remove the Admission Class Item From the IRF-PAI Beginning October 1, 2026, with Minor Modification

  • CMS asserts that the Admission Class Item is currently not used in the calculation of quality measures already adopted in the IRF QRP. It further notes that it is not used for previously established purposes unrelated to the IRF QRP, such as payment, survey, or care planning. This removal will be effective beginning with the FY 2028 IRF QRP (beginning with patients admitted on October 1, 2026); however, IRFs will not be required to collect this item beginning with patients admitted on October 1, 2024.

For additional information, CMS published a fact sheet that provides an overview of the provisions contained in the final rule.

Image by Dirk Wouters from Pixabay

As part of the Independent Regulatory Reform Commission (IRRC) process for the promulgation of new regulations, the Final Form Regulations for the Psychiatric Rehabilitation Services (PRS) have been posted for review and public comment on the IRRC website. This public comment period runs for 30 days. The comments may be submitted by individuals, organizations, associations, etc. on the impacts of the regulations on the systems and individuals they serve.

The purpose of this final-form rulemaking is to amend Chapter 5230 to allow psychiatric rehabilitation services (PRS) to be provided to individuals who are diagnosed with posttraumatic stress disorder, bipolar disorder, major depressive disorder, or anxiety disorders without going through the exception process and to allow individuals who are 14 years of age or older but under 18 years of age who meet the admission requirements to access PRS. In addition, the final-form rulemaking clarifies the documentation that will be reviewed through the exception process to determine if an individual is eligible for PRS as well as revises outdated language.

The Department convened a work group that included stakeholders to review and provide input on the proposed rulemaking. The work group held face-to-face meetings on November 4, 2015; December 8, 2015; and January 28, 2016, to review the current regulation and provide recommendations for the proposed changes, which RCPA and its members took part in.

At this time, we are seeking any further public comment as it relates to these regulations. RCPA intends to submit comments on behalf of our members, though individuals and organizations may submit comments pertaining to the regulations directly to the IRRC website. Please submit your comments to RCPA COO and Mental Health Policy Director Jim Sharp.

The IRRC hearing on the Final Form Regulation Hearing will be held on September 19, 2024, at 10:00 am. RCPA intends to participate in the hearing to speak to our recommendations. If any member would like to attend and or testify, please contact Jim Sharp.

In accordance with DHS rebranding and the Governor’s Office Customer Service Transformation Initiative, the Office of Medical Assistance Programs will be implementing changes to the old URLs to reach PROMISe hosted applications and websites. The old URLs, using a domain naming convention of dpw.state.pa.us, will be changing to dhs.pa.gov in phased implementations beginning August 7, 2024, and wrapping up in October 2024. Please review the PDF listed below, containing the impacted production environment URLs.

See document for specific PROMISE activity URL updates.

Who is Impacted?

  • CWOPA users and registered business partners with active assigned PROMISe role permissions for each URL
  • External persons accessing the Physician Provider Directory Search
  • Providers accessing the Electronic Enrollment Application or logging into the MA and LiHeap Provider Internet Portals

When is this happening?

  • The first URL, Project Workbook access, is scheduled to change on August 7, 2024
  • The remaining URLs will be implemented in phases
  • All phases to be completed by October 1, 2024

How will these changes be communicated?

  • CWOPA users and business partners with active assigned PROMISe role permission to access URLs today will receive targeted email communication shortly before each URL change is implemented
  • Broadcast messages will run on the MA Provider and LiHeap Internet Portals
  • Providers will receive the same messaging via the ListServ
  • For a limited time after implementation, if a user tries to access an old dpw.state.pa.us URL, a redirect message will pop-up for 5 seconds instructing users to save/bookmark the new URL, then continue to the new dhs.pa.gov URL
  • The DHS Communications Office will be making pre-identified updates from old URLS to the new URLs throughout the various DHS website pages

What can I do to aid this transition?

  • The Old PROMISe URLS have been in place for a long time. We are asking for your assistance, post implementation, in identifying any remaining reference to the old URL. These references could be found on DHS SharePoint, HealthChoices Extranet, and DHS web pages or downloadable documents
  • If you discover remaining usage of the old URLs post implementation, please send a message to this email for correction. Be sure to document the exact site location of the reference and include a screen shot to aid in correction efforts.

If you have further questions, please contact the above OMPA Ra account or your respective RCPA Policy Director.