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The Office of Long-Term Living (OLTL) issued an updated guidance and tool that was previously issued on October 13, 2020 regarding the temporary closure and re-opening of settings. This guidance and tool were issued to support providers in their efforts to protect against community spread of COVID-19. The Community Spread Thresholds document has been updated on page two to show that the “Thresholds for Community Spread” section is not applicable to Structured Day Programs. Members should disregard the previous communication.

 

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Today, the Trump Administration released a comprehensive plan that includes proactive measures to remove regulatory barriers and ensure coverage and payment for the administration of an eventual COVID-19 vaccine. To ensure broad access to a vaccine (especially for seniors), the Centers for Medicare and Medicaid Services (CMS) released an Interim Final Rule with Comment Period (IFC) that establishes that any vaccine that received Food and Drug Administration (FDA) authorization, will be covered under Medicare as a preventive vaccine at no cost to beneficiaries. The IFC also implements provisions of the CARES Act that ensures immediate coverage of a COVID-19 vaccine by most private health insurance plans without cost sharing from both in and out-of-network providers during the course of the public health emergency (PHE).

CMS also released a set of toolkits for providers, states, and insurers to help the health care system prepare to swiftly administer the vaccine when available. These resources are designed to increase the number of providers that can administer the vaccine and ensure adequate reimbursement for administering the vaccine in Medicare while making private insurers and Medicaid programs aware of their responsibility to cover the vaccine at no charge to beneficiaries.

Additionally, CMS released new Medicare payment rates for COVID-19 vaccine administration. The Medicare payment rates will be $28.39 to administer single-dose vaccines. For a COVID-19 vaccine requiring a series of two or more doses, the initial dose(s) administration payment rate will be $16.94 and $28.39 for the administration of the final dose in the series. These rates will be geographically adjusted and recognize the costs involved in administering the vaccine, including the additional resources involved with required public health reporting, conducting important outreach and patient education, and spending additional time with patients answering any questions they may have about the vaccine. Medicare beneficiaries, those in Original Medicare or enrolled in Medicare Advantage, will be able to get the vaccine at no cost. CMS is encouraging state policymakers and other private insurance agencies to utilize the information on the Medicare reimbursement strategy to develop their vaccine administration payment plan in the Medicaid program, CHIP, the Basic Health Program (BHP), and private plans. Using the Medicare strategy as a model would allow states to match federal efforts in successfully administering the full vaccine to the most vulnerable populations.

The IFC (CMS-9912-IFC) is scheduled to display at the Federal Register as soon as possible with an immediate effective date and a 30-day comment period.

Additional information on this IFC can be found in the fact sheet.

The COVID-19 vaccine resources for providers, health plans, and State Medicaid programs can be found here.

The FAQs on billing for therapeutics can be found here.

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Harrisburg, PA – Pennsylvanians are encouraged to ask their job search and unemployment compensation (UC) questions during the Pennsylvania Department of Labor & Industry’s (L&I) twenty-third virtual town hall, which will be held from 1:00 pm to 2:00 pm today, Thursday, October 29.

How to Participate in the Town Hall

A livestream will be online at the Pennsylvania Department of Labor & Industry website. Those without Internet access can listen by calling 833-380-0719; however, phone lines are limited, so we ask that they be reserved for individuals who need them.

Participants using the phone lines can ask questions directly of our UC expert. Individuals livestreaming the town hall can submit typed questions that will be read to the UC expert by a moderator. To protect participants’ personal confidential information, detailed answers about individual claim questions cannot be answered during the town hall.

Reminder to Guard Personal Information

L&I recently became aware of fraudsters who are posing as L&I employees during calls to Pennsylvanians. These fraudsters will ask for personal and confidential information such as usernames, passwords, and social security numbers, under the guise of helping with issues related to unemployment compensation. Pennsylvanians are reminded that L&I employees will never call and ask for your username, password, or full social security number.

Scammers have also been posing as L&I and US Department of Labor (DOL) officials in emails and social media messages in attempts to obtain individuals’ personal and confidential information. L&I does not offer assistance over social media due to the inability to guarantee confidentiality and security; as a result, any messages received from “L&I” over social media are likely fraudulent and should be ignored.

Emails appearing to come from L&I or the US DOL may be spoofed by fraudsters. Individuals should never click a link in an email and provide their username and password. The safest way to log into an account is to type the URL of the website into the browser window.

For more information on identifying fraud, what to do if you believe you have been a victim of fraud, or how to report fraud, visit L&I’s website.

MEDIA CONTACT: Sarah DeSantis

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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 sources 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, $457 million of COVID-19 relief funds were allocated to providers of long-term living programs.

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 forms capture provider information; COVID-19 utilization related data; 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 US Department of Treasury website:

DHS is requesting the following two reports from the Office of Long-Term Living (OLTL) providers:

  1. 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 November 6, 2020. To assist providers in projecting eligible costs, DHS recommends using the cost report attached and reporting costs that appear in cells H120 and H165. Providers must report the projected costs through a web-based portal.
  1. 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 must keep all documentation related to the costs reported in the final cost report for a minimum of five years.

Cost Reporting Forms:

In advance of the reports’ due date, DHS recommends that 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.

Thank you for your ongoing assistance during these trying times. Please submit any questions about OLTL Act 24 expense reporting via email.

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Senior Woman Being Served Meal By Carer

This communication is to provide notice to Nursing Home Transition (NHT) Coordination Agencies (NHTCAs) of a proposed change to NHT Tenant-Based Rental Assistance (TBRA). It will also provide an opportunity to offer comments or feedback. Please review this brief notice and offer any comments or questions by the close of business on Wednesday, October 28, 2020.

Earlier this year, the rules for NHT one-time TBRA were modified to allow that, in the event that a landlord cannot or does not wish to provide the information necessary to make the payment via direct deposit, the payment may be directed to the NHTCA assisting with the application. The NHTCA would then be responsible for providing the payment to the landlord.

 

A change has been proposed, which would require each application and payment to be handled as described above. The one-time TBRA payment would be directed to the NHT Coordination Agency instead of the landlord. The NHTCA then would be responsible for providing the payment to the landlord. This change is expected to make the application and payment process faster and more efficient.

 

Please note that this change would apply only to one-time TBRA payments. Any payments still going to landlords through the now discontinued bridge TBRA payment would continue to be made to those existing landlords for up to 24 months.

If you have any questions, comments, or feedback about this proposed change, including the feasibility of this arrangement for your agency or concerns about any negative outcomes this change might cause, please email your feedback to Rachel Sink no later than the close of business on Wednesday, October 28, 2020.

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We’re excited to announce that RCPA’s Direct Care Works initiative is now live. The workforce development pilot project is using social media platforms to engage potential applicants likely to be attracted to careers in health and human services.

We established a presence on Facebook, Twitter, Instagram and YouTube (Look for LinkedIn soon!). As part of the pilot project, paid advertising will drive individuals to the Direct Care Works website, where they can learn more about the field and access job opportunities.

The initial paid campaign is focused on Allegheny County and some of the surrounding areas, yet we welcome members from throughout the Commonwealth to share information about employment opportunities for the job portal, as we will be sharing information on several social media channels that reach a statewide audience.

To include your organization in the DCW Job Portal, email directcareworks@paproviders.org with the following information:

  • Organization’s name and one line program description (approximately 15 words – see job portal for examples)
  • List of regions where your programs are operated (i.e., Central, Northeast, Northwest, Southeast, Southwest)
  • Contact person
  • Website link where potential candidates can view organization information and employment openings

RCPA recently issued a release that details the project. Additionally, a social media toolkit has been developed, for our members to use the collateral materials as a way to enhance recruitment efforts and share the Direct Care Works networks with your own audiences.

For more information, please contact RCPA Children’s Division Director Jim Sharp or email directcareworks@paproviders.org

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a memo is on the keyboard of a computer as a reminder: meeting

The Managed Long-Term Services and Supports (MLTSS) Subcommittee meeting agenda for the November 4, 2020 meeting has been released. The meeting is scheduled for 10:00 am – 1:00 pm and will be held via webcast. The information to participate is available below:

Webinar Link: https://attendee.gotowebinar.com/register/9164975178583542541
Public Call in # and Pin: 1-415-655-0060 Pin: 753-009-978
Remote Streaming Link: https://2020archive.1capapp.com/event/mltss

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