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Brain Injury

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On February 5, 2020, ninety-nine members of the House of Representatives signed and sent a letter to Seema Verma, Administrator, Centers for Medicare and Medicaid Services (CMS), that questions the proposed eight percent cut to therapy services. The proposed cut was included in the calendar year (CY) 2020 Medicare Physician Fee Schedule (MPFS) final rule that was published on November 15, 2019. The letter contained two questions asked of CMS, including the methodology and data that were used in this decision making. The responses to these questions were requested by February 21, 2020. Contact RCPA Rehabilitation Services Division Director Melissa Dehoff with questions.

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The next Community HealthChoices (CHC) Third Thursday webinar has been scheduled for January 16, 2020 from 1:30 pm – 3:00 pm. During this webinar, Office of Long-Term Living’s (OLTL’s) Deputy Secretary Kevin Hancock will provide updates on the CHC program. Providers should register to participate in the webinar. Once registered, a confirmation email will be sent and will include the call information. Questions about the webinar should be directed to OLTL’s Bureau of Policy Development and Communications Management at 717-857-3280.

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The Centers for Medicare and Medicaid Services (CMS) has approved the Office of Long-Term Living’s (OLTL) Community HealthChoices (CHC) Waiver renewal. The renewal became effective on January 1, 2020.

Key changes in the approved waiver include:

  • Revised the Residential Habilitation service definition by modifying the number of hours that are defined as a day unit from a minimum of 12 hours to a minimum of 8 hours.
  • To the service definitions of Job Finding, Job Coaching, Employment Skills Development, Career Assessment and Benefits Counseling, added language that Office of Vocational Rehabilitation (OVR) services are considered to not be available if OVR has not made an eligibility determination within 120 days; and added language to address when employment services through the CHC waiver can be provided should OVR close the order of selection, thereby creating a waiting list for OVR services.
  • Modified the qualifications for Service Coordinators and Service Coordinator supervisors.
  • Clarified that if a CHC Managed Care Organization (MCO) identifies that a participant has not been receiving services for 5 or more days, and if the suspension of services was not pre-planned, then the CHC-MCO must communicate with the participant to determine the reason for the service suspension within 24 hours. If the participant’s health status or needs have changed, the CHC-MCO must conduct a comprehensive needs reassessment of the participant’s needs within fourteen (14) days of identifying the issue.
  • Added that an emergency back-up plan must be included in the Person-Centered Service Plan.
  • Modified language to reflect that the CHC waiver will be fully operational statewide as of January 1, 2020.
  • Updated language to reflect that the Department utilizes IDEMIA as the data system to process fingerprint-based Federal Bureau of Investigation (FBI) criminal record checks.
  • Updated the OLTL bureau names and responsibilities.

Questions surrounding the CHC Waiver Renewal should be directed to the OLTL Bureau of Policy Development and Communications Management at 717-857-3280.

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On this episode of A BATTLE WITHIN, we get to spend some time talking with Kevin McDonald.

Kevin was at the Mind Your Brain Conference in October of this past year. His work is conducted locally and on both the state and federal levels in an effort to help those affected by the invisible injury.

In part one, they cover his own injury from 2009, his recovery process and the support he has had available to him.  We also get to learn a little about what he has been up recently as he continues down the road of trying to improve.

Next we will spend time reviewing his wonderful organization Restart Your Life/Review Your Mind and covering the advocacy work he has down statewide and on the federal level.

You will find much of what Kevin has to say to be important and valuable. Having somebody like this in the fight in our community of warriors is fantastic and deserves to be recognized.

Keep Battling!

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On December 24, 2019, DHS announced the approval of the Department’s Good Faith Effort (GFE) Exemption application for the Electronic Visit Verification (EVV) implementation. This GFE does not change DHS’ expectations of providers of personal care services to comply with the requirements of the 21st Century Cures Act. The Department will continue with a soft launch period through June 30, 2020. Throughout this time, providers must begin using EVV and complete any integration and certification activities if they have not been completed already. The Department continues to develop a policy bulletin that will outline additional requirements, including compliance benchmarks for manually edited visits. This bulletin will be released as soon as it is finalized.

During claims processing in PROMISeTM, EVV validation against the EVV Aggregator will continue to be performed and EVV Error Service Codes (ESCs) will set without impacting claim payment. During the extended soft launch period, the expectation is that provider/provider agency/Agency with Choice and Vendor Fiscal/Employer Agent billing staff will note when the EVV edit(s) set and actively make corrections either to the data stored in the DHS EVV Aggregator or the claim itself to ensure errors do not repeat. DHS will be monitoring which EVV edits set and how often.

Regular updates to the stakeholder community will be made on the progress of the implementation. Outreach and technical assistance will be performed based on results and as applicable. As of July 1, 2020, any claims without a corresponding EVV visit or any mismatches between what is found on the claim versus what is found in the EVV Aggregator will be denied.

2020 EVV Implementation Timeline:

  • January 1, 2020: All Providers must begin using EVV for Personal Care Services (PCS).
  • January 2020 – March 2020: All Providers must complete system integration activities with the DHS Aggregator for fee-for-service programs. Providers who are experiencing difficulties in integrating and will not be ready by March 2020 are asked to submit an extension request using this form, documenting the difficulties they are experiencing no later than February 1, 2020. The completed form should be emailed to the EVV resource account.
  • Starting July 1, 2020: Claims submitted for Personal Care Services without a matching EVV visit will be denied.

If providers have not yet completed the necessary steps to implement EVV, please contact the appropriate entity to complete the necessary training and system integration activities.

OLTL and ODP Fee-For-Service Providers

  • The DHS Sandata system training is available for providers electing to use the DHS Sandata system. Providers using the DHS system must complete this training in order to begin setting up their agency accounts and security permissions. Providers may register for the independent web-based training offered through Sandata here.
  • The DHS Aggregator will receive information from Alternate EVV systems being used by providers in fee-for-service programs.
  • Providers using Alternate EVV systems should contact Sandata at 855-705-2407 to complete Alternate EVV system integration activities for fee-for-service programs.

Current Community HealthChoices (CHC) Providers and Aging, Attendant Care, and Independence Waiver Providers

  • If providers are electing to use the HHAeXchange EVV system offered by the Managed Care Organizations (MCOs), providers must work with the MCOs to complete training and other onboarding requirements.
  • Providers using Alternate EVV systems in CHC will need to send their EVV data to the CHC-MCOs.
  • Providers should contact HHAeXchange to complete Alternate EVV system integration activities for CHC.

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The Office of Long-Term Living (OLTL) will be conducting the next Community HealthChoices (CHC) Third Thursday webinar on December 19, 2019 from 1:30 pm – 3:00 pm. During this webinar, Deputy Secretary Kevin Hancock will provide updates on the CHC program. To participate in the webinar, please register here. Once registered, you will receive a confirmation email that contains the information about joining the webinar. If you have any questions, please contact the OLTL Bureau of Policy Development and Communications Management at 717-857-3280.

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The Centers for Medicare and Medicaid Services (CMS) recently notified the Office of Long-Term Living (OLTL) of the approval of the OBRA Waiver amendment. The amendment is effective on January 1, 2020.

The changes in the approved amendment include:

  • Revise the Residential Habilitation service definition by modifying the number of hours that are defined as a day unit from a minimum of 12 hours to 8 hours.
  • Revise the service definitions of Job Finding, Job Coaching, Employment Skills Development, Career Assessment, and Benefits Counseling to address when employment services can be provided through the OBRA waiver, should the Office of Vocational Rehabilitation (OVR) have a waiting list (closed order of selection) or when OVR has not made an eligibility determination within 120 days.
  • Update the Abuse Registry Screening information to reflect that the Department of Human Services (DHS) utilizes IDEMIA as the data system to process fingerprint-based FBI criminal record checks, as well as other minor changes.
  • Revise cost neutrality estimates to reflect rate changes to the Personal Assistance Services (PAS) and Residential Habilitation waiver services.

If you have any questions, please contact the OLTL Bureau of Policy Development and Communications Management at 717-857-3280.

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As we approach the conclusion of the Governor’s Council on Reform public comment period on December 16, 2019, RCPA would like to ensure that each member has the materials for providing their public comments, feedback, and support. RCPA will be submitting commentary within each policy director’s purview, and we strongly urge your agency to submit your thoughts to the Council, including areas and issues that may not be represented in the current recommendations.

If you would like to send your submissions to your respective policy director for inclusion in the RCPA public comment, please have them submitted by close of business on Wednesday December 11, 2019.

Below you will find the links to important documents relating to the Council on Reform, including the Public Comment Submission Form. If you have further questions, please contact your respective RCPA Policy Director.

  1. Governor’s Executive Order
  2. November 1 Press Release
  3. Recommendation Document
  4. Public Comment Form

Thank you for your efforts and partnership to bring these recommendations to the forefront of your work.

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