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Policy Areas

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The Centers for Medicare and Medicaid Services (CMS) has announced a redesigned Accountable Care Organization (ACO) model that better reflects the agency’s vision of creating a health system that achieves equitable outcomes through high quality, affordable, person-centered care. The ACO Realizing Equity, Access, and Community Health (REACH) Model, a redesign of the Global and Professional Direct Contracting (GPDC) Model, addresses stakeholder feedback, participant experience, and Administration priorities, including CMS’ commitment to advancing health equity.

In addition to transitioning the GPDC Model to the ACO REACH Model, CMS is canceling the Geographic Direct Contracting Model (also known as the “Geo Model”), effective immediately. The Geographic Direct Contracting Model, which was announced in December 2020, was paused in March 2021 in response to stakeholder concerns. A comparison table of ACO REACH and GDCM is available for additional information.

CMS, through the Innovation Center, is testing new models of health care service delivery and payment to improve the quality of care that people receive, including those in underserved communities. The Innovation Center is making improvements to existing models and launching new models to increase participation in our portfolio, and CMS will be a strong collaborator to health care providers that participate in those models.”

As CMS works to achieve the vision outlined for the next decade of the Innovation Center, CMS wants to work with partners who share its vision and values for improving patient care, guided by three key principles. First, any model that CMS tests within Traditional Medicare must ensure that beneficiaries retain all rights that are afforded to them, including freedom of choice of all Medicare-enrolled providers and suppliers. Second, CMS must have confidence that any model it tests works to promote greater equity in the delivery of high-quality services. Third, CMS expects models to extend their reach into underserved communities to improve access to services and quality outcomes. Models that do not meet these core principles will be redesigned or will not move forward.

REACH ACOs will be responsible for helping all different types of health care providers — including primary and specialty care physicians — work together, so people get the care they need when they need it. In addition, people with Traditional Medicare who receive care through a REACH ACO may have greater access to enhanced benefits, such as telehealth visits, home care after leaving the hospital, and help with co-pays. They can expect the support of the REACH ACO to help them navigate an often complex health system.

The GPDC Model will continue until December 31, 2022, and then will transition to the ACO REACH Model. The first performance year of the redesigned ACO REACH Model will start on January 1, 2023, and the model performance period will run through 2026. CMS is releasing a Request for Applications for provider-led organizations interested in joining the ACO REACH Model. Current participants in the GPDC Model must agree to meet all the ACO REACH Model requirements by January 1, 2023, in order to participate.

The following is a list of March event dates for PA Family Network Workshops, monthly updates, and group meetings. Flyers containing event descriptions, details, and Zoom links are included. All the events are virtual and being held through Zoom.

Safety in the Community Workshop:
March 1, 2022 10:00 am–12:00 pm

Waiver Basics (101) Part 1 Workshop:
March 15, 2022 10:00 am–12:00 pm

Waiver Basics (101) Part 2 Workshop:
March 15, 2022 1:00 pm–3:00 pm

Advanced Waiver Part 1 Worskhops:
March 2, 2022 6:00 pm–8:00 pm
March 17, 2022 10:00 am–12:00 pm
March 21, 2022 6:00 pm–8:00 pm
March 29, 2022 6:00 pm–8:00 pm

Advanced Waiver Part 2 Worskhops:
March 3, 2022 6:00 pm–8:00 pm
March 17, 2022 1:00 pm–3:00 pm
March 23, 2022 6:00 pm–8:00 pm
March 31, 2022 6:00 pm–8:00 pm

Transition Workshop:
March 8, 2022 10:00 am–12:00 pm

Long-Term Planning Workshop:
March 22, 2022 10:00 am–12:00 pm

Sibling Good Life Group Meeting:
March 7, 2022 6:30 pm–8:30 pm

Family Forum: Updates:
March 16, 2022 6:30 pm–7:30 pm

The ODP Annual Data Report provides statistical information to educate our stakeholders about the individuals ODP serves and the services they receive. This data provides an important overview of the service system ODP oversees that supports individuals with disabilities. The accompanying resource, Everyday Lives: Values in Action Information, Sharing and Advisory Committee (ISAC) Recommendations, Strategies, and Performance Measures, provides information on indicators of success used to gauge the effectiveness of the work of ODP.

The 2020–2021 Annual Data Report is available by using either of the following links:

Everyday Lives: Values in Action Information, Sharing and Advisory Committee (ISAC) Recommendations, Strategies, and Performance Measures publication is available here.

A Financial Management Services (FMS) stakeholder meeting has been scheduled for March 4, 2022, from 1:00 pm–2:30 pm. This public meeting will include a discussion on the upcoming changes for the administration of FMS under the Community HealthChoices (CHC), OBRA Waiver, and Act 150 Programs. Representatives from both the CHC Managed Care Organizations (MCOs) and the Office of Long-Term Living (OLTL) will be in attendance to discuss the upcoming changes.

Registration is required to participate. Once registered, participants will receive a confirmation email containing information about joining the webinar.

If you choose to use your phone to call in, please use the numbers below:
Dial in: (562) 247-8321
Access Code: 625418280#
Audio PIN: shown after joining the webinar

ODP Announcement 22-023 is to remind providers that are required to take the Modified Medication Administration Training Course of upcoming renewal requirements. On February 13, 2020, the Office of Developmental Programs (ODP) released ODP Announcement 20-014 titled “New ODP Regulation Update: Clarification Regarding Medication Administration Requirements.”

Among other things, Announcement 20-014 specified that “in accordance with § 6100.468(d), life sharers and service locations that are not licensed by the Department (DHS) will be required to successfully complete a modified medication administration course…staff required to take the course must do so by July 1, 2020, to be compliant with the regulatory requirements,” and that “staff, contractors, and consultants who are required to take the Modified Medication Administration Training Course must also take a renewal course every 2 years that must occur no later than the last day of the 24th month following the previous completion date.”

Based on the above, the Modified Medication Administration Training Course period is now active. To satisfy the renewal requirement, the current Modified Medication Administration Training course must be retaken in its entirety. To allow for ample time to complete the course for renewal, ODP is allowing for those who first took the course in February 2020 to complete the renewal requirement by March 31, 2022.

The Modified Medication Administration Course may be accessed on MyODP. Questions, comments, or requests for technical assistance relating to this announcement may be submitted via email.

Act 126 of 2020 amended the original 2012 Methadone Death and Incident Review (MDAIR) Act, which established the creation of a team to review methadone-related deaths or incidents, to go beyond methadone and include a review of death and incidents related to any Food and Drug Administration (FDA)-approved medication to treat opioid use disorder as a primary, secondary, or contributing factor to a death or incident.

As a result of the new law, the Pennsylvania Department of Drug and Alcohol Programs selected a new MDAIR team to review medication-related deaths, communicate concerns, and develop best practices to prevent future medication-related deaths and incidents.

A list of the new team members can be found here.

The Health Resources and Services Administration (HRSA) is making more than $560 million in Provider Relief Fund (PRF) Phase 4 General Distribution payments to more than 4,100 providers across the country this week. Providers will receive an email notification by Thursday, February 24 if their application was among those processed in this latest batch. HRSA is working to review all remaining applications as quickly as possible.

With today’s announcement, a total of nearly $11.5 billion in PRF Phase 4 payments has now been distributed to more than 78,000 providers in all 50 states, Washington D.C., and five territories. This is in addition to HRSA’s distribution of American Rescue Plan (ARP) Rural payments, totaling nearly $7.5 billion in funding to more than 44,000 providers since November 2021.

Learn More

  • The Department of Health and Human Services (HHS) published a press release on February 24 and an updated state-by-state table detailing all Phase 4 payments made to date.
  • As individual providers agree to the terms and conditions of Phase 4 payments, it will be reflected on the public dataset.

If you have any further questions, please contact your RCPA Policy Director.