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Brain Injury

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House Republican Appropriations Chairman Seth Grove will lead a roundtable discussion with Medicaid (MA) Managed Care Organizations (MCOs) on February 7, 2023, at 10:00 am.

Committee Chairman Grove will be joined by House members and the following testifiers:

  • Emily Katz, Executive Director of PAMCO;
  • Joanne McFall, Market President of Keystone First;
  • Matthew Hurford, President/CEO of Community Care Behavioral Health;
  • James Schuster, Chief Medical Officer of UPMC Insurance Services Division;
  • Jack Carroll, Executive Director of Cumberland-Perry Drug & Alcohol Commission;
  • John Koehn, Market President of Community HealthChoices, AmeriHealth Caritas;
  • Justin Davis, Plan President/CEO of PA Health & Wellness; and
  • Brendan Harris, Vice President of Community HealthChoices, UPMC Health Plan.

The hearing will be held in Room 60 East Wing, Main Capitol, State Capitol Complex in Harrisburg. The hearing will also be streamed live.

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The monthly Managed Long-Term Services and Supports (MLTSS) Subcommittee convened on February 1, 2023. The meeting handouts included the agenda as well as the following PowerPoint presentations:

UPDATE on 02/06/23 — In addition to the above handouts, the following are now available:

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Thursday, March 2, 2023
Start time: 10:00 am
End time: 3:00 pm
Break: 12:00 pm – 1:00 pm

This meeting will be hybrid, with the in-person portion held at the Best Western Premier in Harrisburg (800 E. Park Dr., Harrisburg, PA) and the virtual portion held via Zoom. The public is invited to attend in person or connect to this meeting using the following information:

You are invited to a Zoom webinar.
When: March 2, 2023, 10:00 AM Eastern Time (US and Canada)
Topic: PA State Board of Vocational Rehabilitation Quarterly Meeting
Please visit this link to join the webinar.
Passcode: 210559
Or One tap mobile:
US: +19292056099,,85656724729#,,,,*210559# or +13017158592,,85656724729#,,,,*210559#
Or Telephone:
Dial (for higher quality, dial a number based on your current location):
US: 1-929-205-6099 or 1-301-715-8592 or 1-305-224-1968 or 1-309-205-3325 or 1-312-626-6799 or 1-646-931-3860 or 1-669-444-9171 or 1-669-900-6833 or 1-689-278-1000 or 1-719-359-4580 or 1-253-205-0468 or 1-253-215-8782 or 1-346-248-7799 or 1-360-209-5623 or 1-386-347-5053 or 1-507-473-4847 or 1-564-217-2000
Webinar ID: 856 5672 4729
Passcode: 210559

CART and sign language interpreters will be available during this meeting. Those using a screen reader can connect via the following link: CART.

The agenda for this meeting can be found on the State Board’s web page. Anyone who would like to make public comment prior to the meeting may submit their comments via email. Additional auxiliary aids and services are available upon request to individuals with disabilities. Please send your request electronically.

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Hole torn in a dollar bill with medicaid text

Because of the continuous coverage requirement, states were able to use additional money from the federal government during the federal public health emergency (PHE) for health care programs like Medicaid if they kept people covered. Therefore, Pennsylvanians did not lose their Medicaid/Medical Assistance (MA) or CHIP coverage if their income changed or they did not complete a renewal during the PHE.

However, starting April 1, 2023, Pennsylvania and other states will have to start disenrolling people if households are ineligible for MA at the time of their renewal or do not complete their renewal. The Pennsylvania Department of Human Services (DHS) will have to return to normal renewal processing procedures for Pennsylvanians enrolled in MA and the CHIP. Renewals will be completed over 12 months. Everyone with MA or CHIP coverage will need to submit a renewal to see if they are still eligible.

In Pennsylvania, approximately 3.5 million people rely on Medicaid. Last year, it was estimated that about 500,000 of those would lose coverage when the continuous coverage requirement ended, creating access issues for individuals and exacerbating financial challenges for providers.

The Pennsylvania Department of Human Services has created an online resource, including a stakeholder toolkit as well as a guide on how to become a helper, that provides resources for groups like providers to communicate ways for Pennsylvanians who receive MA or CHIP coverage to continue their coverage.

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Greenspace Health has their next educational panel in the calendar, focused on a topic relevant to all of you — the value of therapeutic alliance. Dr. Brent Mallinckrodt, co-author of the 18-item “Brief Revised Working Alliance Inventory” (BR-WAI), will share the importance of the client-clinician relationship, the three vital components of a strong therapeutic alliance, and how to best use the BR-WAI in practice. To round out the conversation will be Emily Miller, a Master’s Level Psychotherapist and National Clinical Counselor from Pinebrook Family Answers in Pennsylvania, speaking on her experience of using the BR-WAI in practice and the impact it’s had on her clients’ outcomes.

You won’t want to miss this opportunity to learn more about one of the most important predictors of positive symptom change for people in care: the working alliance.

Register here: How To Measure and Improve Therapeutic Alliance — February 23 at 1:00 pm EST.

Watch this short video for highlights from the last educational panel hosted by Greenspace Health, featuring the Yale Measurement-Based Care Collaborative!

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Message from the Office of Developmental Programs:

Pennsylvania Department of Human Services (DHS) Acting Secretary Val Arkoosh today advised Pennsylvanians of upcoming changes to Supplemental Nutrition Assistance Program (SNAP) benefits. Due to the passage of the recent federal Consolidated Appropriations Act of 2023, starting in March, SNAP recipient households will no longer receive the Emergency Allotment (EA) additional payment created during the COVID-19 public health emergency and will resume receiving one SNAP payment per month.

This change will happen for all SNAP recipients, with households receiving letters via mail about the change in SNAP payments.

“We know this additional SNAP payment has been a lifeline for people over the past three years and that ongoing economic uncertainty and high food prices are contributing to food insecurity for many Pennsylvanians. There is help available for you and your family through Pennsylvania’s heroic charitable food partners,” said Acting Secretary Val Arkoosh. “I urge anyone who can donate food or resources, now is the time to help your local food assistance programs as they prepare to meet this potential additional need.”

With funds made available due to the federal COVID-19 emergency, DHS began providing EAs as a second monthly payment to SNAP recipient households that were receiving benefits since March 2020. The EAs increased the SNAP budget amount to the maximum available amount for their household size or, since early 2021, were a minimum of $95. These payments were distributed separate from the initial payment as an extra payment each month.

Due to federal legislation, this February will be the last month EAs are sent; and starting in March, SNAP recipients will only receive one regular SNAP payment.

Additionally, the 2023 cost of living adjustment for Social Security Income (SSI), which is also set by the federal government, prompted an 8.7 percent increase to SSI income. SNAP eligibility thresholds — also set at the federal level — did not rise proportionally. Because of this, approximately 249,000 households will experience a decrease in their base SNAP benefits by an average of $40 per household, which will take effect in March when EAs end. The Office of Developmental Programs (ODP) anticipates approximately 5,000 to 20,000 households will be disenrolled from SNAP due to the SSI increase. These federal changes will primarily affect older Pennsylvanians and seniors.

Pennsylvanians who need to report changes to their household size, income, or expenses are encouraged to report any changes either online via the myCOMPASS PA mobile app or by calling DHS’s Customer Service Center at 877-395-8930 (or 215-560-7226 for Philadelphia residents). This will help ensure households are receiving the maximum SNAP benefit based off their individual circumstances.

DHS recognizes the impact these changes may have on households and wants to make sure families that need food assistance know where to go for help:

  • SNAP recipients who are pregnant or have kids under 5 may be able to get help buying food from PA WIC. You can call 800-WIC-WINS or apply online.
  • You can call 211 or visit PA 211 to connect with various local food resources.
  • Visit Feeding PA to find local food banks and other food assistance programs.
  • Go to the DHS website or PA Department of Agriculture website for information on assistance programs and other resources.
  • If you are a SNAP eligible senior citizen, apply to receive additional vouchers redeemable at more than 800 farm stands and more than 200 farmers’ markets in Pennsylvania. The Senior Food Box Program can also provide you with additional shelf-stable groceries. Learn more about these programs from the Pennsylvania Department of Agriculture.

“Our charitable food network works tirelessly every day to be a resource and safety net for their communities. With a reduction in SNAP benefits coming, they will likely be left to absorb much of the impact,” said Acting Secretary Arkoosh. “If you are able to help, I strongly encourage you to support your local food banks and pantries as they prepare to meet this need. Small donations can grow into a big difference, so please do what you can so they can continue their life-saving work.”

For more information about SNAP Emergency Allotments, visit the DHS website.

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The Centers for Medicare and Medicaid Services (CMS) has updated the calendar year (CY) 2023 per beneficiary threshold amounts for therapy services. These threshold amounts, also known as therapy caps, are reflected on claims with the KX modifier to confirm that services are medically necessary as justified by appropriate documentation in the medical record. There is one amount for Physical Therapy (PT) and Speech-Language Pathology (SLP) services combined and a separate amount for Occupational Therapy (OT) services. Claims from providers for therapy services above the threshold amounts without the KX modifier are denied.

For CY 2023, the KX modifier threshold amounts are: (a) $2,230 for PT and SLP services combined, and (b) $2,230 for OT services.

For additional information, refer to CMS Transmittal 11626 and the 2023 Therapy Code List and Dispositions.

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