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Medical Rehab

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DHS and PDA Invite Brain Injury Providers to Meet With MCOs Interested in Community HealthChoices

The Departments of Human Services (DHS) and Aging are continuing to develop Community HealthChoices (CHC), Pennsylvania’s plan for managed long-term services and supports. The success of CHC will be determined by a number of factors, including the relationships between future managed care organizations (MCOs) and existing providers. It is extremely important to continue the conversation with MCOs and Pennsylvania’s experienced providers, to successfully transform the fee-for-service system to managed care.

An invitation has been extended to RCPA’s Brain Injury Committee members to participate in an upcoming MCO meet and greet session, exclusively for brain injury providers. As a part of this invitation, we were asked to establish a panel and presentation, as well as participate in a facilitated discussion with the MCOs. Because of the importance of this meeting, please plan on sending at least one representative from your organization to this event. We have also been asked to submit questions we may have for the MCOs prior to the meeting date.

The meeting is scheduled for Thursday, January 14 from 11:30 am to 2:30 pm at the Hilton Harrisburg, 1 North 2nd Street. This will be a working lunch meeting (boxed lunches will be provided to registered attendees). Registration/RSVP is required.

Please respond to Melissa Dehoff if you will be attending. Responses are due no later than Monday, January 11, so the list of attendees can be provided prior to the meeting and the appropriate number of lunches ordered.

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The Bureau of Autism Services (BAS) is conducting a preliminary survey to help inform the design of services for individuals with autism spectrum disorder (ASD) who are transitioning out of high school, including those who may have had justice intersections or psychiatric hospitalizations. This survey is designed to be completed by professionals with or without experience supporting individuals with ASD ages 18-25. BAS is asking for feedback on both surveys by Friday, January 1.

BAS has developed two versions of this survey; one for individuals and families, and another to be completed by professionals. The professionals survey can be completed here. Any questions about these surveys can be directed to the Bureau of Autism Services via email.

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Time is running out; the deadline for revalidating is Thursday, March 24, 2016. Numerous RCPA members have already gone through this process, but it appears that large numbers of providers have not yet done so. A special provider revalidation webinar will be held by RCPA on Wednesday, January 6 at 10:00 am. Jamie Buchenauer, from the Department of Human Services, will be presenting the webcast.

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On December 11, 2015, the Centers for Medicare and Medicaid Services (CMS) posted an update to the inpatient rehabilitation facility (IRF) quality reporting spotlight & announcements page of their website, regarding an extension of the IRF quality reporting program data submission. CMS made the decision to extend the National Healthcare Safety Network (NHSN) data submission deadline for IRF providers until Monday, February 15, 2016. The extension also applies to the submission deadline to the calendar year 2015 quarters 1 and 2, fiscal year 2017 payment determination. In addition, the extension applies to the submission deadlines for assessment data for the quality reporting program.

Members are encouraged to run the applicable CMS output reports within their facility prior to each quarterly reporting deadline. Detailed guidance on how to run and interpret these reports, and additional information, are posted on the Centers for Disease Control and Prevention (CDC) website. Additionally, once these reporting deadlines have passed, members should run the advanced analysis reports within NHSN to view when each data element was first entered and last modified, to determine whether all data were complete at the time of the reporting deadline.

Additional information on how to run and interpret these reports is provided by the CDC/NHSN. Questions on the reports within NHSN should be directed to the NHSN help desk. Additional questions can be directed to the CMS help desk.

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Pursuant to Executive Order 1996-1, the State Board of Physical Therapy (PT) has requested member comments and suggestions on two draft rulemakings.

The first draft rulemaking, 16A-6518-Foreign Trained Evaluation, would amend the board’s regulations so that a foreign-trained applicant would be required to submit an evaluation showing that the applicant’s training was equivalent to what is required in a program accredited by the Commission on Accreditation in Physical Therapy Education (CAPTE) — the accrediting body for United States programs — rather than program contents specified in the regulations.

The second draft rulemaking, 16A-6519-Student in Master’s Program Statement of Policy, is for a statement of policy that would make clear that, for purposes of the exception to the licensure requirement for physical therapy students, the term “Board-approved School” includes all physical therapy programs at a school that has a program accredited by CAPTE, as CAPTE accredits only pre-licensure programs.

The State Board of PT welcomes comments on these draft rulemakings. Comments are due by Friday, January 15, 2016, and should be submitted via email. Please specify rulemaking 16A-6518 (foreign-trained applicant evaluation) or 16A-6519 (student in master’s program) as appropriate on your comments.

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On December 10, 2015, the Legislative Budget and Finance Committee (LB&FC) released and presented their report, Implementation of the PA Safety in Youth Sports Act, pursuant to HR 2014-1064. This bill called on the House of Representatives to direct the LB&FC to assess compliance with the Safety in Youth Sports Act, determine the best practices for managing concussions and traumatic brain injuries, and make recommendations on provisions of the act that should be strengthened to be more effective.

While changes were not recommended to the current act, there was concern expressed that concussions are still not taken as seriously as they should be. As a result, it was recommended that the Pennsylvania Department of Education (PDE) develop additional guidelines and recommended practices for schools to follow with regard to identifying, assessing, and managing student athletes suspected of having sustained a concussion. The recommendation was made to PDE to consider the guidelines developed by the New York Department of Education (Guidelines for Concussion Management in the School Setting) as a possible model. The report was accepted and approved to be released.

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This article from Capitolwire is a good and extensive overview of what is going on with the budget here in Harrisburg. Health and Human service budget line items are still fluid until the House and Senate negotiate a final budget deal. RCPA will provide updates on any budget deal, and RCPA encourages members to continue to contact the governor and state legislators to inform them why it’s necessary for them to pass a state budget sooner rather than later. Questions, contact Jack Phillips.

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On Thursday, December 10, 2015, from 12:30–1:30 pm, the Centers for Medicare and Medicaid Services (CMS) will conduct a special open door forum to provide a summary of the dry run for inpatient rehabilitation facilities (IRFs) on all-cause unplanned readmissions for 30-day post discharge from IRFs. To participate in the call, dial: 800-837-1935; conference ID: 93892614. Prior to the call, the presentation slides will be posted to the IRF Quality Reporting Spotlight & Announcements page on the CMS website.

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On November 23, the leadership of the Office of Mental Health and Substance Abuse Services (OMHSAS), including Deputy Secretary Dennis Marion and Medical Director Dr. Dale Adair, provided a webcast presentation on the development of Applied Behavior Analysis (ABA) services for children with an Autism Spectrum Disorder (ASD). The webcast to more than 130 RCPA members reviewed the current concepts and recommendations developed by a clinical work group, assisting OMHSAS in the development of ABA medical necessity guidelines, clarifying the authorization pathway for Behavioral Health Rehabilitation Services for children and adolescents diagnosed with Autism Spectrum Disorder.

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