ReelAbilities Film Festival Showcases a Wide Range of People Living With Disabilities
Emergency Preparedness Requirements for Medicare & Medicaid Providers Released
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.
RCPA Announces New Director of Children’s Division
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!
RCPA Board of Directors Announcement
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.
Community HealthChoices MCOs Announced
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.
Information from DHS Webinar: Act 62 Next Steps for Providers and Families
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.
Certified Investigators Forums to be Held September 8
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.
Webinar: Act 62 Next Steps for Providers and Families
RCPA is collaborating with key state agencies to host a very important webinar on changes impacting providers of child and adolescent autism services as well as HealthChoices managed care organizations. Representatives from the Department of Human Services (DHS) will review Act 62 of 2008, billing guidance for providers, and the revised ICD-10 diagnostic codes and intervention procedure codes related to children and adolescents with autism spectrum disorders. These codes may apply to both commercial health plans and Medical Assistance plans. The webinar will also include updated information and guidance for families. Registration is now open for both sections of the webinar.
The webinar will be held in two sessions on Thursday, August 25, 2016:
- Session 1, 12:00–1:00 pm: The target audience for this webinar session is BH-MCOs, counties, and county oversight organizations.
- Session 2, 1:00–2:00 pm: The target audience for this webinar session is behavioral health and pediatric rehabilitation provider organizations.
All participants are welcome to sit in for either or both sessions. Both webinars will be recorded and made available on RCPA and state websites. The DHS Bulletin related to the changes in diagnostic and intervention procedure will be sent to members once it is issued.
ODP QM Certification
ODP Announcement 049-16: QM Certification Fall Registration Now Open and Fall 2016 registration; ODP has been offering training on quality management practices on an ongoing basis since 2003. In order to support moving the system forward in partnership and collaboration, ODP is now offering its staff and stakeholders an opportunity to become ODP QM Certified. In November 2015, ODP announced (Announcement 105-15) the availability of the ODP QM Mailbox. ODP staff and stakeholders were encouraged to send their interest in becoming certified to ODP and begin to complete the prerequisites. Since that time, ODP has heard from over 160 interested parties and the list continues to grow. This announcement includes information about the fall 2016 classes, the registration process, and the deadline for submission of the application, which is August 15, 2016. A registration form is available as well.
IDD Update July 29, 2016
ODP Announcement 047-16; Frequently Asked Questions for Targeted Services Management Bulletin Now Posted
On January 20, 2016, ODP issued bulletin 00-16-01 entitled Targeted Services Management for Individuals with an Intellectual Disability. The purpose of the bulletin was to communicate and clarify the requirements for targeted services management that were approved by the Centers for Medicare and Medicaid Services on April 15, 2015.
Since the release of the bulletin, ODP has received many inquiries from stakeholders. To address these inquiries, ODP has developed a document entitled Frequently Asked Questions (FAQs) Targeted Services Management Bulletin. Updates will be made to the FAQ document as more questions are received.
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