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Policy Areas

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The Pennsylvania Athletic Trainers’ Society, through a grant from the Pennsylvania Department of Health, brings you “A Consumer’s Guide to the Management and Care of Concussion in Sport.” This program gives a detailed look at the importance of proper identification and treatment of sport concussion, and the role of the licensed athletic trainer as part of the health care team to manage these injuries appropriately. The Safety in Youth Sports Act directs schools and athletic programs to create a health care team, and a concussion policy action plan, to aid in the management of concussions. This program will air on the Pennsylvania Cable Network (PCN) during the “Sunday Fusion” programming on the following dates and times:

  • Sunday July 26, 3:30 pm
  • Sunday August 2, 2:30 pm
  • Sunday August 9, 5:30 pm
  • Sunday August 16, 2:30 pm
  • Sunday August 23, 4:00 pm

Beginning Monday, July 20 the program will be available on the PCN website.

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On July 14, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule in the Federal Register, announcing the implementation of a new Medicare Part A and B payment model called the Comprehensive Care for Joint Replacement (CCJR) model. Under this model, acute care hospitals in 75 selected geographic areas would receive retrospective bundled payments for episodes of care for lower extremity joint replacement or reattachment of a lower extremity. All related care within 90 days of hospital discharge from the joint replacement procedures will be included in the episode of care.

CMS anticipates the proposed CCJR model would benefit Medicare beneficiaries by improving the coordination and transition of care, improving the coordination of items and services paid through Medicare fee-for-service, encouraging more provider investment in infrastructure and redesigned care process for higher quality and more efficient service delivery, and incentivizing higher value care across the inpatient and post-acute care spectrum spanning the episode of care. According to CMS, hip and knee replacements are the most common inpatient surgery for Medicare beneficiaries and can require lengthy recovery and rehabilitation periods.

CMS proposes to test CCJR for a five year performance period, beginning January 1, 2016, and ending December 31, 2020. Comments will be accepted on the proposals contained in the proposed rule, as well as other alternatives or suggestions, through September 8. Contact Melissa Dehoff at RCPA with questions.

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The Centers for Medicare and Medicaid Services (CMS) has released an updated inpatient rehabilitation facility patient assessment instrument (IRF PAI) training manual that includes updated information on new items that become effective for IRF discharges occurring on or after October 1. These new items, including the arthritis attestation item and therapy information, were finalized in the IRF prospective payment system fiscal year 2015 final rule. The Updated IRF PAI Training Manual, Helpful Resources Document and Section 2 (Item by Item Coding Instructions) are located in the “Downloads” section of the IRF PAI web page. CMS has also made available a YouTube video slideshow from the January 2015 national provider call that focused on training providers how to code and complete these new items on the IRF PAI.

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On July 14, Estelle Richman, former secretary of the Department of Human Services (DHS), will conduct a presentation; Person-Driven Services in Managed Care Long-Term Services and Supports (MLTSS), from 1:00 to 3:00 pm at Temple University, Ritter Annex Room 555, 1301 Cecil B. Moore Avenue, Philadelphia, PA 19122. Members can participate in person or online.

Topics will include:

  • Overview of DHS discussion document on managed care;
  • Overview of federal options for self-directed services and supports in managed care; and
  • Discussion of what stakeholders can do to ensure that good self-directed options are available in any managed care model that DHS administers.

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On July 1 Governor Wolf signed Act 15 (HB 1276) into law. The bill was drafted to “clarify and make more explicit provisions” about which employees and adult volunteers, who work or volunteer with children, must obtain criminal background check clearances and child abuse clearances. It was intended to clarify the new Child Protective Services Law (CPSL) and to address concerns expressed by numerous volunteer-based organizations. Some of the key changes to the CPSL made by HB 1276 include:

  • Adds definitions of adult family member, direct volunteer contact, education enterprise, family child-care home, immediate vicinity, and matriculated student.
  • Reworks the definition of program, activity, or service to further flesh out definition.
  • Limits the employees, at institutions of higher learning, required to undergo background checks, while retaining required checks for adults who have direct contact with youth who remain enrolled in high school.
  • Clarifies which adults will require background checks and need to be in the “vicinity” of the child during an internship, externship, work-study, co-op, or similar program.
  • Extends to 60 months (vs. 36 months) the time frame by which employees and volunteers must have their background checks updated.
  • Expands the portability of the checks.
  • Exempts volunteers, who are also students, from the background checks under specific conditions (e.g., the student is enrolled in school, the student is volunteering for an event on school grounds, or the event is not for children who are part of a child-care service).
  • Permanently waives the fees associated with volunteers completing state background checks.
  • Includes a presumption of “good faith” for agencies screening employees and volunteers.

A very comprehensive analysis of HB 1276 with an analysis table has been produced by The Center for Children’s Justice and is available on their website.

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