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Medical Rehab

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The Traumatic Brain Injury (TBI) Advisory Board, which is established under section 1252 of the Federal Traumatic Brain Injury Act of 1996, will convene for their public meeting on Friday, May 5, 2017, from 10:00 am to 3:00 pm in the large conference room of the Community Center, 2nd Floor, Giant Food Store located at 2300 Linglestown Road, Harrisburg, PA 17110.

The Board assists the Department of Health in understanding and meeting the needs of persons living with traumatic brain injury and their families. This quarterly meeting will provide updates on a variety of topics including the number of people served by the Department of Health’s Head Injury Program (HIP). In addition, meeting participants will discuss budgetary and programmatic issues, community programs relating to traumatic brain injury, and available advocacy opportunities.

For additional information, or for persons with a disability who wish to attend the meeting and require an auxiliary aid, service, or other accommodation to do so, contact Michael Yakum, Division of Community Systems Development and Outreach, 717-772-2763, or for speech and/or hearing impaired persons, contact V/TT 717-783-6514 or the Pennsylvania AT&T Relay Service at 800-654-5984.

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RCPA has joined the many community organizations across Pennsylvania that are now participants in the #FamilyFirstPA Coalition. #FamilyFirstPA is a campaign committed to enabling families to advocate for themselves in the ongoing effort to protect human services in the state budget process. The project works with provider, advocacy, faith-based, and community organizations to identify FAMILIES and provide social media platforms for them to share their stories of the challenges they face and the critical support their family has received from community services that rely on state and county funding. While these families may not know about funding streams, waivers, etc., they know what a difference critical human services are making in the lives of their families. In the current phase of the project, #FamilyFirstPA is seeking and interviewing families in four regions:

  • Lehigh Valley: Berks, Lehigh, Northampton Counties
  • Southeast: Bucks, Chester, Montgomery, Delaware Counties
  • South Central: Dauphin, Lancaster, York Counties
  • Southwest: Allegheny, Washington, Westmoreland Counties

More information about the project can be found online and providers and families are encouraged to “like,” participate in, and “follow” #FamilyFirstPA on Facebook and Twitter.

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In the March 21, 2017 Federal Register, the Centers for Medicare and Medicaid Services (CMS) published an interim final rule with comment period (IFC) to again delay the effective date of the final rule (originally published in the January 3, 2017 Federal Register), implementing the three new Medicare Parts A and B episode payment models, changes to the existing Comprehensive Care for Joint Replacement (CJR) Model, and the Cardiac Rehabilitation Incentive model. The effective date has been delayed from March 21 to May 20. According to the interim final rule, the delay is necessary to allow time for additional review. The new payment models and the updated CJR Model allow clinicians additional opportunities to qualify for a five percent incentive payment through the Advanced Alternative Payment Model (APM) path under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and the Quality Payment Program.

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Please join the Office of Long-term Living (OLTL) and the Office of Mental Health and Substance Abuse Services (OMHSAS) for an informational webinar on Community HealthChoices (CHC) on Friday, March 31, 2017 at 1:00 pm. The webinar will feature a presentation from OLTL’s Chief of Staff, Kevin Hancock. Kevin will provide an update on CHC, describe progress to date, and discuss next steps. There will be an opportunity for questions and answers at the end of the presentation.

Background on CHC
The commonwealth is in the process of implementing CHC. CHC is a mandatory managed care program for eligible individuals, providing physical health services and long-term services and supports, such as attendant care services. CHC is being geographically phased in across the commonwealth beginning in January of 2018 in 14 counties in southwestern Pennsylvania, followed in July 2018 by five counties in the southeastern portion of the commonwealth. The CHC implementation will be completed in January 2019, when the remaining counties are implemented. The move to CHC will assist DHS in continuing to provide quality services.  CHC managed care organizations will be required to coordinate covered services, Medicare, and behavioral health services for enrolled participants.

To register for the webinar, please follow this link. Once you have registered, you will receive a confirmation email containing connection information. Please note, the connection information you receive will be unique to you and should not be shared with others.

Reminder: All CHC-related information can be found here. Comments can be submitted electronically. If you have any questions, please contact the Office of Long-Term Living Bureau of Policy and Regulatory Management at 717-783-8412.

A listserv has been established for ongoing updates on the CHC program, titled OLTL-COMMUNITY-HEALTHCHOICES. If you would like to update or register your email address, please follow this link.

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The Centers for Medicare and Medicaid Services (CMS) recently announced a Medicare Learning Network (MLN) call that will focus on the Standardized Patient Assessment Data Collection Project. The call has been scheduled for Wednesday, March 29, 2017, from 1:30 pm to 3:00 pm EDT

During the call, information will be shared about the efforts to develop, implement, and maintain standardized Post-Acute Care (PAC) patient assessment data, including pilot testing results and plans for an upcoming national field test. Additional agenda topics include:

  • Goal of the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act);
  • Timeline of activities;
  • Alpha 1 results;
  • Alpha 2 progress;
  • Plans for beta test; and
  • How to get involved.

The IMPACT Act requires the reporting of standardized patient assessment data by PAC providers, including inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), home health agencies (HHAs), and long-term care hospitals (LTCHs).

To register for the call, please visit the MLN Registration page.

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On January 12, 2017, the Centers for Medicare and Medicaid Services (CMS) published in the Federal Register a proposed rule on requirements for qualified practitioners/suppliers for prosthetics and orthotics that interprets Section 427 of the Benefits Improvement and Protection Act (BIPA) of 2000. Some of the provisions included in this proposed rule include:

  • Qualifications required for practitioners to furnish and fabricate, and qualified suppliers to fabricate prosthetics and custom-fabricated orthotics;
  • The accreditation requirement that qualified suppliers must meet in order to bill for prosthetics and custom-fabricated orthotics;
  • The timeframe in which qualified practitioners and qualified suppliers must meet applicable licensure, certification, and accreditation requirements;
  • The requirements that an organization must meet in order to accredit qualified suppliers to bill for prosthetics and custom-fabricated orthotics;
  • Removal of the current exemption from accreditation and quality standards for certain practitioners and suppliers; and
  • The sanction for submitted claims for payment of custom-fabricated orthotics or prosthetics without the required qualifications.

Essentially, the proposed rule would require physical therapists and occupational therapists to meet the Durable Medical Equipment, Prosthetics/Orthotics, and Supplies (DMEPOS) quality and accreditations when they furnish and fabricate prosthetics or custom orthotics under the Medicare program. Additionally, therapists who furnish and fabricate custom orthoses must be licensed by the state (as a qualified provider of prosthetics and custom orthotics), or certified by the American Board for Certification in Orthotics and Prosthetics or by the Board for Orthotists/Prosthetists Certification.

Comments on this proposed rule are due by Monday, March 13, 2017.

The American Society of Hand Therapists (ASHT) has developed a detailed summary of this proposed rule, as well as a sample letter that members can reference to pull relevant facts when developing comment letters in response to this proposed rule.

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Department of Human Services (DHS) Secretary Ted Dallas spoke at the RCPA Board of Directors meeting on February 22 regarding Governor Wolf’s proposal to consolidate four state health and human service agencies. If approved by the legislature, the plan would be launched on July 1, 2017.

Although the Secretary referenced approximately $90 million in savings from this process, he also affirmed that this “cannot be just about saving money.” Dallas remarked that time spent dealing with the bureaucracies as currently constructed takes time away from providing services, and so the goal is to eliminate redundancies.

RCPA members brought up key topics such as population health, licensing, and services for persons with co-existing conditions. When asked how this consolidation will affect addressing the opioid crisis, Secretary Dallas responded that the focus would be shifted to treating the whole person, rather than each individual condition.

The meeting concluded with the Secretary requesting ideas for continued efficiencies and how to ultimately better serve members. On the day of the Governor’s announcement, RCPA issued a statement expressing support for the proposal and committing to working with the administration to implement the plan in a smart and cost-effective manner.

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The Centers for Medicare and Medicaid Services (CMS) published a final rule; delay of effective date notice in the February 17, 2017 Federal Register that delays the effective date of the rule, “Advancing Care Coordination Through Episode Payment Models (EPMs); Cardiac Rehabilitation Incentive Payment Model; and Changes to the Comprehensive Care for Joint Replacement (CJR) model.” This notice clarifies that, in accordance with the White House’s regulatory freeze, provisions of CMS’ bundled payment final rule that were to become effective on February 18, 2017, are now delayed until March 21, 2017.

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