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Intellectual & Developmental Disabilities

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Yesterday, a Texas federal judge issued a temporary injunction to the Department of Labor’s (DOL) overtime rule. In granting the preliminary injunction, the federal judge said the DOL’s overtime rule exceeds the authority the agency was granted by Congress.

As you may recall, the DOL’s overtime rule was announced in May, and it has been opposed by many businesses and nonprofits. The rule was to take effect on December 1 of this year. Now with yesterday’s ruling, it is likely that President-elect Trump’s administration, which opposed the rule, will have time to review it and make changes and/or roll back various provisions contained in the current rule.

The DOL could appeal the Tuesday ruling, but with the Obama administration only having approximately two months in office, an appeal is unlikely. With many RCPA members already implementing and announcing changes to comply with the DOL’s overtime rule, it might be difficult for those members to roll back these changes, because it may impact employee morale. As further information is released, RCPA will provide additional guidance to members. Please contact Jack Phillips, RCPA Director of Government Affairs with any questions.

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The Centers for Medicare and Medicaid Services (CMS) published a final rule in the September 16, 2016 Federal Register that establishes national emergency preparedness requirements for Medicare and Medicaid participating providers and suppliers to plan adequately for both natural and man-made disasters, and coordinate with federal, state, tribal, regional, and local emergency preparedness systems. It will also assist providers and suppliers to adequately prepare to meet the needs of patients, residents, clients, and participants during disasters and emergency situations. The effective date of the regulations are effective on November 15, 2016.

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Robena Web Edited

RCPA is pleased to announce the hiring of Robena Spangler as the new director for its Children’s Division. Robena has worked for NHS Human Services for many years in several key positions, including operations resource specialist, regional director – children’s services, director of out of home services and gender responsive services, and children and youth program specialist. In addition to her bachelor’s degree in sociology/human services, she holds an MS degree in leadership and professional advancement from Duquesne University.

Robena will begin in this position on September 26 – just in time for the RCPA Annual Conference. As many of you know, Connell O’Brien serves as the current children’s services director and will be retiring. Connell will remain with RCPA to assist in the transition and to continue with select initiatives. Please join us in welcoming Robena to RCPA!

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The RCPA Board of Directors is pleased to announce the appointment of Steven Alwine, CEO of HealthSouth Rehabilitation Hospital of York, as its newest member. Steve has worked at HealthSouth for almost 25 years. He was promoted in 2002 to chief financial officer at HealthSouth Nittany Valley and returned to York in 2011 as chief executive officer. He currently fills a vacancy for an unexpired term ending June 30, 2017, as an RCPA director-at-large.

In addition, the board also selected Charles Barber, CEO of Erie County Care Management, Inc., to complete the unexpired term ending June 30, 2017, as board treasurer. Charlie has already been serving on the RCPA Board of Directors, but was recently voted to fill the vacant officer position of treasurer.

Join us in congratulating these individuals in their appointments. For a complete listing of the RCPA board members, please visit our website.

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The Departments of Human Services (DHS) and Aging just announced their selection of three managed care organizations (MCOs) for Community HealthChoices (CHC). CHC will coordinate physical health and long-term services and supports (LTSS) to individuals who are dually eligible for Medicare and Medicaid, older Pennsylvanians, and individuals with disabilities.

Through a review of a request for proposals, the following MCOs have been selected to proceed with negotiations to deliver services statewide in Pennsylvania beginning in 2017:

  • AmeriHealth Caritas
  • Pennsylvania Health and Wellness (Centene)
  • UPMC for You

CHC will roll out in three phases. Persons eligible for CHC are individuals aged 21 or older who have both Medicare and Medicaid, or who receive long-term services and supports through Medicaid because they need help with everyday activities of daily living.

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On August 25, RCPA, in collaboration with key state agencies, hosted a webinar on changes impacting providers of child and adolescent autism services as well as HealthChoices managed care organizations. The webinar also reviewed the use of behavioral health, physical health, and rehabilitation procedure codes that reflect services for the diagnostic assessment and treatment of ASD covered under Act 62. The procedure codes that are on the MA Program fee schedule will be subject to the cost avoidance process for MA FFS claims beginning September 30.

The webinar also included a review of updated information and guidance for families that providers can duplicate and make available to families of children with an autism spectrum disorder. Visit the DHS Act 62 web page for resources to use when communicating with families, including:

  • Fact Sheet
  • Frequently Asked Questions
  • How to Appeal
  • Sample Appeal Letters
  • Act 62 Infographics

Representatives from the Department of Human Services (DHS) and the Insurance Department reviewed the recently issued Medical Assistance (MA) Bulletin for providers relating to Act 62 titled, Payment of Claims for Services Provided to Children and Adolescents for the Diagnostic Assessment and Treatment of Autism Spectrum Disorder (ASD). The purpose of this bulletin is to remind providers enrolled in the MA Program, both fee-for-service and HealthChoices, of the requirement to bill a child’s or adolescent’s private health insurance company before submitting a claim for the diagnostic assessment or treatment of ASD. New codes will be implemented by September 30. The recording of the webinar is available for review. The Power Point presentations for both the managed care and the service provider presentations are also now available.

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In ODP Memo 057-16, ODP shares details about upcoming forums for certified investigators (CIs). The forums are an opportunity for CIs and other interested parties to learn about changes to the ODP CI program, as well as to receive technical assistance and hear about best practices. There will be two sessions held on Thursday, September 8. Registration closes September 1. Details about how to register are included in the memo. The forums are sponsored by ODP and Temple University’s Institute on Protective Services.

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