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Policy Areas

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The agenda for the December 7, 2022 Managed Long-Term Services and Supports (MLTSS) Subcommittee meeting was just released by the Office of Long-Term Living (OLTL). The meeting will be held in person (Honors Suite, 1st Floor, 333 Market St, Harrisburg, PA 17126) and via webcast from 10:00 am – 1:00 pm. To receive the information to join the meeting, please register in advance.

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The Centers for Medicare and Medicaid Services (CMS) published the calendar year (CY) 2023 Medicare Physician Fee Schedule (MPFS) in the Federal Register for November 18, 2022. Some of the key provisions contained in the final rule include (and are effective on January 1, 2023):

Medicare Telehealth Services

  • Addition of new HCPCS codes to the list of Medicare telehealth services on a Category 1 basis.
  • Implementation of the 151-day extensions of Medicare telehealth flexibilities, including allowing telehealth services to be provided in any geographic area and in any originating site setting.
  • Permission for physical therapists, occupational therapists, speech-language pathologists, and audiologists to provide telehealth services.
  • Listing of codes added to the telehealth services list are here.

Evaluation & Management (E&M) Visits

  • For CY 2023, CMS finalized changes for “Other E/M” visits that parallel the changes that were made in recent years for office/outpatient E/M visit coding and payment. Other E/M visits include hospital inpatient, hospital observation, emergency department, nursing facility, home services, residence services, and cognitive impairment assessment visits.

Behavioral Health

  • Proposal finalized to create a new HCPCS code (G0323) describing General Behavioral Health Integration performed by clinical psychologists or clinical social workers to account for monthly care integration where the mental health services provided are serving as the focal point of care integration.

Chronic Pain Management

  • Finalized a CY 2023 proposal to create two new G codes (G3002 and G3003) performed by physicians and other qualified health professionals describing monthly CPM for payment starting January 1, 2023.

Opioid Treatment Programs (OTPs)

  • CMS finalized the proposal to allow the OTP intake add-on code provided via 2-way, interactive, audio-video technology when billing for the initiation of treatment with buprenorphine using audio-video technology to start treatment with buprenorphine as authorized by the Drug Enforcement Administration (DEA) and Substance Abuse and Mental Health Services Administration (SAMHSA) at the time the service is provided.
  • CMS also finalized the proposal to permit the use of 2-way, interactive, audio-only technology to start treatment with buprenorphine in cases where audio-video technology isn’t available to the patient and all other applicable requirements are met.

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Last week Senator Bob Casey became a cosponsor on the Latonya Reeves Freedom Act (S.3417). This legislation would create a right to live in the community with related support for Home and Community-Based Services (HCBS) provisions. The Latonya Reeves Freedom Act of 2021/22 also has housing rights, including an accessible housing provision for people with disabilities to live in the community.

Here is a related press release summarizing the legislation from the lead sponsor of S.3417 from Senator Michael Bennett (D-CO).

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The Department of Health and Human Services (HHS) released a new report that highlights patients’ experience of Long COVID to better understand its complexities and drive creative responses by government leaders, clinicians, patient advocates, and others. The Health+ Long COVID Report builds on President Biden’s Memorandum on Addressing the Long-Term Effects of COVID-⁠19 and the two previously issued HHS Long COVID reports. The report was commissioned by HHS and produced by Coforma, an independent third-party design and research agency. It provides recommendations on how to deliver high-quality care and relevant and intentional resources and supports to individuals and families impacted by Long COVID.

Last week, the Administration sent a $750 million dollar supplemental funding request to Congress to support Long COVID research and treatment. This funding request would support HHS and their continued work on Long COVID, providers who serve patients with Long COVID and its associated conditions, and community-based organizations that assist with case management and provide other essential services and supports.

The report offers a variety of short-term and longer-term recommendations that come directly from the patient experience.

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PATF has released two brand new editions of their fully accessible financial education guides — Cents and Sensibility: A Guide to Money Management, 7th Edition and the Educator Companion Manual, 2nd Edition.

Cents and Sensibility addresses the financial education needs of people with disabilities while providing comprehensive strategies, activities, and resources for anyone who wants to have control over their money.

The book provides the tools people need to make informed financial decisions and tackles financial topics like how to save for the future without losing benefits that impact individuals with disabilities.

Download the Free Guide

Educator Companion Manual, 2nd Edition, aligns with chapters from Cents and Sensibility, and provides educators and instructors with strategies for addressing the unique financial education needs of students with disabilities.

Each section in the Manual includes topic objectives, key terms, and essential questions, which provide guidance for teaching the lessons included in Cents and Sensibility.

The Educator Companion Manual helps anyone taking on an educator’s role to engage all students in financial education. The Manual includes financial education topics such as earning, saving, credit, and decision making.

The instructional materials correlate with the National Standards for Financial Education and Pennsylvania Academics Standards.

Download the Free Manual

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ODP Announcement 22-117 serves to announce a 30-day public comment period on the Residential and Community Participation Support (CPS) service locations that the Office of Developmental Programs (ODP) proposes to submit to the Centers for Medicare and Medicaid Services (CMS) for Heightened Scrutiny. Public comment on each service location will be accepted until 11:59 pm on December 19, 2022.

A summary of ODP’s findings for each Residential and CPS service location that ODP has determined meets one or more of these criteria is available at MyODP and DHS. A description of the process ODP used to identify service locations, complete reviews, and make determinations is also available on both websites.

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The Centers for Medicare and Medicaid Services (CMS) announced that the next hospital/quality initiative open door forum has been scheduled for November 29, 2022, at 2:00 pm. Agenda topics for the call include:

  • Announcements & Updates
    • Hospital Price Transparency Sample Format Announcement
    • OPPS/ASC Final Rule Policies
    • Rural Emergency Hospital (REH) Policies
      • REH Conditions of Participation
      • REH Payment
      • REH Enrollment
      • REH Physician Self-Referral Law Update
    • OPPS Payment Policies
      • Annual Update
      • Remote Behavioral Health Services
      • 340B Drugs
      • Clinic Visit — Rural Sole Community Hospital Exemption
      • Payment Adjustment for Domestically Made N95 Masks
    • ASC Payment Policies
      • Annual Update
      • Non-Opioid Alternatives Under Section 6082 of the SUPPORT Act
    • Partial Hospitalization Program Policies
    • Organ Acquisition Payment Policies
      • Counting Research Organs
      • Costs of Potential Organ Donors for Cardiac Deaths
  • Open Q&A

To participate: dial 888-455-1397 and reference conference passcode: 5109694.

Instant replay (audio recording) of the call will be available: 888-562-0227 through December 1, 2022. No passcode is needed.

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