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Policy Areas

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On February 15, 2023, the Centers for Medicare and Medicaid Services (CMS) released a proposed National Coverage Determination (NCD) that power seat elevation equipment on Group 3 power wheelchairs falls within the benefit category for durable medical equipment (DME).

CMS is proposing that the evidence is sufficient to determine that power seat elevation equipment is reasonable and necessary for individuals using power wheelchairs when all of the following conditions are met:

  • The individual performs weight bearing transfers to/from the power wheelchair while in the home, using either their upper extremities during a non-level (uneven) sitting transfer and/or their lower extremities during a sit to stand transfer. Transfers may be accomplished with or without caregiver assistance and/or the use of assistive equipment (e.g. sliding board, cane, crutch, walker); and,
  • The individual has undergone a specialty evaluation by a practitioner who has specific training and experience in rehabilitation wheelchair evaluations, such as a physical therapist (PT) or occupational therapist (OT), that assesses the individual’s ability to safely use the seat elevation equipment in the home.

The proposed NCD is open for public comment for 30 days. The 30-day comment period will close on March 17, 2023.

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Image by PIRO4D from Pixabay

ODP Announcement 23-019 is to advise all stakeholders that the COVID-19 PHE is officially ending May 11, 2023. All provisions made under Appendix K will expire on November 11, 2023.

The Office of Developmental Programs (ODP) will release more detailed information regarding transition activities as they develop. A link to the Department of Health and Human Services (HHS) statement is provided here.

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The monthly Long-Term Services and Supports (LTSS) Subcommittee convened on February 14, 2023. The meeting handouts included the agenda and a PowerPoint presentation from the Office of Long-Term Living (OLTL). Some of the topics in their presentation included:

  • COVID-19 Vaccination Rates From the Community HealthChoices Managed Care Organizations (CHC-MCOs);
  • CHC Request for Information (RFI) Update;
  • Electronic Visit Verification (EVV);
  • Independent Enrollment Broker (IEB) Enrollment Data;
  • LIFE Enrollments;
  • Medical Assistance (MA) Unwinding;
  • Appendix K Waiver; and
  • Home and Community-Based Services (HCBS) Settings Rule.

The next LTSS Subcommittee meeting is scheduled for April 11, 2023.

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The Office of Developmental Programs (ODP) held two informational webinars regarding the new waiver amendments that became effective in January 2023. Some of the changes will go into effect when Appendix K expires, most likely in November of 2023. Other changes are in effect now. The recordings of the sessions are available on MyODP.

The presentation from the February 6 “Adult Autism Waiver Amendment” webinar is available here.

The presentation from the February 9 “Waiver Renewals Effective January 1, 2023: Consolidated, Community Living, and P/FDS Waivers” webinar is available here.

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In early March 2022, the National Alliance for Direct Support Professionals (NADSP) embarked on its first ever national advocacy event, the 2022 Advocacy Symposium, Amplifying The Voices Of Direct Support Professionals (DSPs). Attendees participated in over 250 meetings with legislative staff to share the perspective of direct support professionals to the forefront of Congress during a time of unprecedented workforce challenges. The result of our attendees’ advocacy culminated in additional sponsors to the House of Representatives and US Senate bills regarding establishing a Standard Occupation Classification within the Bureau of Statistics for direct support professionals (S. 1437 / H.R. 4779).

NADSP is excited to announce the return of the Advocacy Symposium on May 3 – 4, 2023! Ahead of this two-day virtual event, attendees will receive comprehensive advocacy training along with planning sessions with state leaders. The success of our first Advocacy Symposium is directly a result of and informed by the people who are on the frontlines of supporting people with disabilities to live, work, and thrive in the community.

We’re looking forward to amplifying even more direct support professional voices in 2023. This event is free and open to direct support professionals, frontline supervisors, self-advocates, family members, and people with disabilities. Registration for this event will open on February 28.

NADSP’s Current 2023 Policy Priorities:

  • Establish a Standard Occupational Classification (SOC) for direct support professionals within the Bureau of Labor Statistics (BLS).
  • Assure effective implementation of workforce development initiatives authorized through legislation that leads to wages commensurate with the level of responsibility and the complexity of this work, as well as career ladder opportunities that lead to professional growth.

Learn More

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The Office of Mental Health and Substance Abuse Services’s (OMHSAS) February 2023 Stakeholder webinar is scheduled for next Friday, February 24, 2023, from 1:00 pm – 2:00 pm. The February Stakeholder webinar was rescheduled due to conflicts with the quarterly Mental Health Planning Council (MHPC) meeting.

Register for the meeting here. After registering, you will receive a confirmation email containing information about joining the webinar.

Call-in Number: (914) 614-3221
Access Code: 458609184#

If you have any questions or would like RCPA to submit a topic for the webinar, please contact RCPA Policy Director Jim Sharp.

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Tuesday, March 7, 2023
1:00 pm – 1:30 pm ET
Join the Provider Integrity in Medicaid Home Personal Care Services webinar with Kirit Pandit, VP, Data and Analytics. Preventing fraud, waste, and abuse (FWA) in the Medicaid market is an on-going effort, with many providers, payers, and vendors involved in the effort to improve the health care system.

During this session, you can expect to:

  • Learn about the analytics dashboards developed to mine data and identify these cases;
  • See our vision for application of analytics for program integrity in home personal care services; and
  • Understand how the development of the dashboards can lead to further insights and actions to support the efforts of state and compliance programs.

Reserve your spot today, and stay tuned for information about more upcoming Empower webinars!

Reserve Your Spot!

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ODP Announcement 23-017 provides information regarding Remote Supports as a separate, discrete service in all four of the Office of Developmental Programs’ (ODP) waivers. Remote Supports is no longer covered as a component of the Assistive Technology service in the Consolidated, P/FDS, and Community Living waivers.

Guidance in the announcement includes how to add remote supports to the ISP, necessary provider qualifications, and enrollment process. Please refer to Attachment A for more instructions on how to add Remote Supports services for the P/FDS, Community Living, or Consolidated Waiver. Please refer to Attachment B for more instructions on how to add Remote Support Services for the AAW. Additional information about the qualification of a new specialty is contained in ODP Announcement 22-122 “Provider Qualification Process.”

Existing providers must submit the approved DP 1059 (ID/A) or DP 1088 (AAW) along with the “PROMISe™ Provider Service Location Change Request,” which can be found on the MyODP website, to the ODP provider enrollment inbox and/or AAW provider enrollment inbox in order to add a new Specialty 364 to an EXISTING active service location with the same Provider Type. Providers that do not have a Provider Type 51 service location open in PROMISe will need to submit an application through the Provider Enrollment system.

Questions regarding ISP requirements should be sent to the appropriate ODP Regional Office. Questions regarding provider qualification requirements should be sent to the ODP Provider Qualification inbox and the AAW Provider Enrollment Lead.

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