The Centers for Medicare and Medicaid Services (CMS) has released a new Frequently Asked Question (FAQ) document that addresses how their review contractors (Medicare Administrative Contractors, Recovery Audit Contractors, and the Supplemental Medical Review Contractor) will conduct medical reviews after the COVID-19 public health emergency (PHE). Read the FAQ here.
The Department of Human Services (DHS) published a notice in the Pennsylvania Bulletin for November 12, 2022, that announces revisions to the Medical Assistance (MA) fee schedule for the OBRA Waiver and the Act 150 Program: Personal Assistance Services (PAS) (Agency with Choice) and Respite (Agency with Choice).
DHS proposes the following substantive and technical changes to the OBRA Waiver:
The proposed OBRA Waiver amendment and a summary of all revisions are available for review on the OLTL Waiver Amendments, Renewals, and Accompanying HCBS Transition Plans web page under Additional Resources.
The following table provides the procedure code and rates for PAS (Agency with Choice):
| Region | OBRA Waiver and Act 150 |
Procedure Code | Modifier | Rate | Unit |
| 1 | X | W0164 | N/A | $4.02 | 15 minutes |
| 2 | X | W0164 | N/A | $3.89 | 15 minutes |
| 3 | X | W0164 | N/A | $4.12 | 15 minutes |
| 4 | X | W0164 | N/A | $4.58 | 15 minutes |
The following table provides the procedure code and rates for Respite (Agency with Choice):
| Region | OBRA Waiver and Act 150 |
Procedure Code | Modifier | Rate | Unit |
| 1 | X | W0165 | N/A | $4 | 15 minutes |
| 2 | X | W0165 | N/A | $3.90 | 15 minutes |
| 3 | X | W0165 | N/A | $4.12 | 15 minutes |
| 4 | X | W0165 | N/A | $4.59 | 15 minutes |
Interested persons are invited to submit written comments regarding these fee schedule rates and the proposed amendment to the Department of Human Services, Office of Long-Term Living, Bureau of Policy Development and Communications Management, Attention: Robyn Kokus, P.O. Box 8025, Harrisburg, PA 17105-8025. Comments can also be sent via email. Use ”OBRA 2023” as the subject line. Comments received within 30 days will be considered in subsequent revisions to the fee schedule or for revisions to the proposed amendment.
The revisions to the fee schedule and the amendment are proposed to take effect April 1, 2023.
The Department of Human Services’ (DHS) Office of Long-Term Living (OLTL) published the proposed amendment to the Community HealthChoices (CHC) Waiver in the Pennsylvania Bulletin for November 12, 2022.
DHS and OLTL are proposing to amend the CHC Waiver by adding Agency with Choice as a Financial Management Services (FMS) model for the participant-directed services of Personal Assistance Services (PAS) and Respite. This would modify Service Coordinator and Service Coordinator Supervisor qualifications to align with the CHC Agreement and to amend the service definitions for the following CHC waiver services:
Also proposed is a technical change to the waiver by revising performance measures.
The proposed CHC waiver amendment and summary of all revisions are available for review on the OLTL Waiver Amendments, Renewals, and Accompanying HCBS Transition Plans web page under Additional Resources.
Interested persons are invited to submit written comments regarding the proposed waiver amendment to the Department of Human Services, Office of Long-Term Living, Bureau of Policy Development and Communications Management, Attention: CHC 2023 Waiver Amendment, P.O. Box 8025, Harrisburg, PA 17105-8025. Comments may also be submitted to the Department via email. Use ”CHC 2023 Waiver Amendment” as the subject line. Comments received within 30 days of publication of this notice will be reviewed and considered for revisions to the proposed waiver amendment.
The proposed amendment will be effective April 1, 2023.
Webinar
Sponsored by Streamline Healthcare Solutions, featuring Microsoft
Why EHR Infrastructure Matters: Streamline and Microsoft Discuss How Different Hosting & Deployment Options Impact Performance, Security, and Cost
Behavioral Health and Human Services organizations have a choice of hosting and deployment options when selecting an Electronic Health Record (EHR) system, and which option they choose has a significant impact on performance, security, and cost. Join executives from Streamline Healthcare Solutions and Microsoft as they discuss the most common hosting and deployment options, including the SaaS model, single-tenant vs multi-tenant architecture, and cloud hosting.
Speakers:
Andy Pitman U.S. Director, Health and Human Services, Microsoft
Matt Chamberlain EVP of Sales and Marketing, Streamline Healthcare Solutions
Javed Husain, Co-Founder & CEO, Streamline Healthcare Solutions
Solome Tibebu, Founder & CEO, Going Digital: Behavioral Health Tech
Webinar Date: Wednesday, November 30, 2022
Time: 12:00 pm – 1:00 pm CT
REGISTER HERE
Are You Leaving Employee Retention Tax Refund Money on the Table?
Your nonprofit may be eligible for up to $26,000 per employee, paid in the form of a refund by the IRS, if you had to partially or fully suspend operations due to government orders OR experienced a significant revenue decrease during the COVID-19 pandemic. RCPA has partnered with First Nonprofit to provide our members with an opportunity to determine if you are eligible and, if so, provide a reputable, vetted, and affordable service to assist you in filing. Take this five-question survey to find out if you are eligible.
Use this link for information about the Nonprofit Employee Retention Tax Refund.
Contact Cheryl Jones with any additional questions:
cjones@firstonprofit.com
612-308-4283
“Homeward Bound: Exploring Issues Faced by Justice-Involved Persons”
The 30th Annual Forensic Rights and Treatment Conference, brought to us by Drexel University, will be presented this year with a spectacular online educational program addressing clinical, policy, and environmental issues that impact persons involved with the criminal justice system. RCPA highly recommends this engaging experience, and members can see further details, including registration, in the conference brochure.
The plenary sessions will address implicit bias, false confessions, Megan’s Law, and an overview of the pardons process. The workshops will offer skill-building sessions to use in your own settings. All sessions will be recorded, which will allow you to earn additional continuing education credits by viewing sessions at your convenience. The conference will be available to registrants until December 31, 2022, and you will be able to see all of the workshop offerings.
For more information contact Drexel via email or call 215-831-4055. If you have additional questions, please contact RCPA Policy Director Jim Sharp or Carol Ferenz.
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