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Policy Areas

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The Centers for Medicare and Medicaid Services (CMS) has announced that the next hospital/quality initiative open door forum will be conducted on April 16, 2024 at 2:00 pm. The agenda topics that will be discussed during the call include:

The call will be a Zoom webinar with registration and login instructions below. To participate by webinar, please register in advance.

Meeting ID: 160 823 4591
Passcode: 200020

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

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The Office of Developmental Programs (ODP) has shared the attached communication, ODPANN 24-035: Action Required in Preparation for Enterprise Case Management (ECM). This communication is to request providers’ assistance in updating their contact information and service information to ensure accuracy in the Home and Community-Based Services System (HCSIS) and in PROMISe™ prior to the Enterprise Case Management (ECM) transition. Please review the announcement for additional information and detail.

ATTACHMENTS:

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The 2024 Virtual Dual Diagnosis Conference, titled “Full Diagnosis: Impact of Trauma, Physical Health, and Metabolic Health,” will take place on Saturday and Sunday, May 22 and 23, 9:00 am to 4:00 pm. Hosted by The Pennsylvania Department of Human Services, Office of Developmental Programs, and Office of Mental Health and Substance Abuse Services, the conference features nationally recognized speakers who will explore various perspectives on these crucial issues. Featured speakers include Dale Adair, MD, FAPA, Syard Evans, PhD, Beth Barol, Stacy Nonnemacher, Self Advocates United as 1, Brandi Kelly, PhD, and Dan Dubovsky. Registration for the conference is open.

If you have any questions, please contact RCPA COO and Director of Mental Health, Jim Sharp.

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Lack of BH Providers in Medicare and Medicaid Impedes Enrollees’ Access to Care

The Office of the Inspector General (OIG) has released a report citing there are not enough behavioral health providers participating in Medicare and Medicaid networks.

In an analysis published April 2, the government watchdog studied one urban and one rural county in 10 states across the country. The analysis found relatively few behavioral health providers are participating in Medicaid, Medicare, and Medicare Advantage programs, leading to difficulties in access for enrollees.

Notable Findings:

  1. On average, there were fewer than five active behavioral health providers accepting Medicare and Medicaid patients per 1,000 enrollees. Traditional Medicare had the lowest rates of providers, at 2.9 per 1,000 on average, and Medicare Advantage had the highest rate at 4.7 per 1,000 enrollees.
  2. Rural counties had fewer providers accepting Medicare and Medicaid than urban counties. In rural counties, there were 1.5 providers accepting traditional Medicare per 1,000 patients, compared to 4.4 in urban counties.
  3. Across Medicaid, traditional Medicare, and Medicare Advantage, there were fewer than two providers per 1,000 enrollees that could prescribe medication for mental health issues, such as psychiatrists and psychiatric nurse practitioners.
  4. Active providers accepting public insurance make up around one-third of the behavioral health workforce, according to the report.
  5. Fewer than 10% of public insurance beneficiaries received mental health treatment in 2023.
  6. CMS could also tighten network adequacy standards in Medicare Advantage and Medicaid to increase the size of insurers’ networks, the OIG said in its report.
  7. The OIG recommended CMS up its oversight of Medicaid and Medicare enrollees’ use of behavioral health services, and recommended CMS examine allowing more types of behavioral health providers to participate in Medicare and Medicaid.
  8. CMS said it concurred with the OIG’s recommendations and said it has already taken several steps to improve access to behavioral health providers for Medicare and Medicaid beneficiaries.

If you have questions please contact RCPA COO and Director of Mental Health Jim Sharp.

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Image by Gerd Altmann from Pixabay

RCPA’s 2024/25 membership year begins July 1, and this week marks the beginning of our membership renewal period. You can download the membership applications directly from the RCPA website on our Join/Renew page. Dues are owed by July 1, 2024.

Please contact Tieanna Lloyd at (717) 963-3609 or via email with any questions, and thank you for your continued support of the association. We look forward to working with you during the 2024/25 membership year!

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Photo by Mathew Schwartz on Unsplash

On Monday, April 8, 2024, there will be an eclipse event and parts of Pennsylvania will have a view of a total solar eclipse. The Office of Developmental Programs (ODP) is reminding everyone that it is not safe to directly view an eclipse with the unprotected eye. Severe eye damage or blindness can occur. It is only safe to view an eclipse through specialized eye protection for solar viewing. Regular sunglasses, even if they are very dark, will not protect your eyes. Viewing any part of the bright sun through a camera lens, binoculars, or a telescope without a special-purpose solar filter secured over the front of the lenses will instantly cause severe eye injury.

When considering any outdoor activities during the eclipse, be aware that some individuals may not understand the risk for eye damage and blindness by looking at the sun without protect eyewear or may be at risk to remove their protective eyewear.

The National Aeronautics and Space Administration (NASA) has created a website with information about safe eclipse viewing.

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Medicare binary sign concept illustration design over black

The Centers for Medicare and Medicaid Services (CMS) has announced two days of interactive training webinars that will cover Medicare basics. The webinars will be offered on April 16 and 17, 2024, from 1:00 pm – 3:30 pm. Attendees can attend one or both days, and space is limited. CEUs will not be offered. The topics for the webinars include:

Day 1 — Medicare enrollment and eligibility; SSA and CMS roles and responsibilities; cost and coverage under Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance); why enrolling on time is important; and an overview of Medicare Supplement Insurance (Medigap) policies.

Day 2 — Medicare drug coverage (Part D); Medicare Advantage Plans; coordination of benefits; how to detect and report suspected Medicare fraud, waste, and abuse; and different resources to help you find answers to Medicare policy and coverage questions.

To register for these events, visit the CMS National Training Program website. The webinars will be recorded and posted to the NTP website. To view the recordings, visit here.

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College of Direct Support Webinar — Discover How DirectCourse Can Revolutionize Your Organization
April 18, 2024
10:00 am
Register

This webinar is for providers within the state of PA who oversee a workforce that provides services and supports to individuals with disabilities in their home and/or employment setting. Discover how, through DirectCourse, you can educate and empower Direct Support Professionals (DSP) to do their best work for the individuals they support in your community.

What DirectCourse Offers:

  • Foundational Training: Perfect for newcomers to the field.
  • Compliance Training: Content that meets regulatory standards.
  • Skill-building Modules: For those seeking to elevate their expertise.
  • Advanced Content: Tailored for seasoned professionals.
  • Specialty Training: For targeted projects and circumstances.
  • Leadership Training: For those at the helm of policy and practice design.
  • Career Path Options: For those looking to advance in the field of Direct Support Professionals.

Our Commitments:

  • Up-to-Date Training: Our online training curricula align with the latest research.
  • Strong Partnerships: We value our bonds with content developers from university partners.
  • Skill-Based Training: Our content is rooted in specific skills and competencies, ensuring clear on-the-job training.
  • Building Connections: We foster connections between families, providers, board members, supervisors, and everyone in the support industry.
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