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Physical Disabilities & Aging

The Office of Long-Term Living (OLTL) has issued a notice regarding the implementation of a temporary change in the processing of 180-day claims exception requests. This change was made due to the Commonwealth employees who work in Dauphin County and the Capitol Complex that were instructed to telework as of March 16, 2020 to mitigate the spread of COVID-19. While these employees were teleworking, OLTL reduced access to the physical site where paper mail is delivered. Therefore, OLTL is requesting that providers email their requests and supporting documentation until further notice.

Providers should follow the instructions below when submitting 180-day claims exception requests via email:

When submitting claims for 180-Day review electronically, please be sure to only send one email per recipient.

Subject line must include:

  • 9-digit PROMISe™ Provider ID and four-digit service location code
  • Recipient First and Last name
  • From and To Dates of Service

*Example: 123456789-0001 John Smith 1/1/2019–6/30/2019

 Nursing Facility claim requests must attach supporting documentation in the following order:

Direct Care Provider claim requests must attach supporting documentation in the following order:

  1. 1500 Claim form completed correctly according to the billing guide.
    1. CMS-1500 Billing Guide for PROMISe ™ Home Health Agencies
  2. Include documentation to support untimely billing.
    – Include letter on company letterhead detailing the reason for untimely filing.
    *This can be communication between the Provider and Service Coordination Agency.
    – Any updated service authorizations.

Questions regarding these instructions should be directed to the OLTL Provider Helpline at 800-932-0939, Option 2.

FOR IMMEDIATE RELEASE
Contact: HHS Press Office
202-690-6343
[email protected]

The U.S. Department of Health and Human Services (HHS) is reminding eligible providers that they have until tomorrow, June 3, 2020, to accept the Terms and Conditions and submit their revenue information to support receiving an additional payment from the Provider Relief Fund $50 billion General Distribution. All providers who automatically received an additional General Distribution payment prior to 5:00 pm, Friday, April 24th, must provide HHS with an accounting of their annual revenues by submitting tax forms or financial statements. These providers must also agree to the program Terms and Conditions if they wish to keep the funds. Providers who have cases pending before the department for adjudication with regard to eligibility for general distribution funding will not be impacted by this closure. All cases needing individual adjudication will need to be received by HHS no later than June 3, 2020.

The submission of tax forms or financial statements to the portal will also serve as an application for additional funding for those providers that have not already received an additional General Distribution payment. If these providers do not submit their revenue information by June 3, they will no longer be eligible to receive potential additional funding from the $50 billion General Distribution.

President Trump is providing support to healthcare providers fighting the COVID-19 pandemic through the bipartisan CARES Act and the Paycheck Protection Program and Health Care Enhancement Act, which provide $175 billion in relief funds to hospitals and other healthcare providers, including those on the front lines of the coronavirus response. This funding supports healthcare-related expenses or lost revenue attributable to COVID-19 and ensures uninsured Americans can get treatment for COVID-19.

HHS previously announced $50 billion of the Provider Relief Fund was allocated for general distribution to facilities and providers that bill Medicare and were impacted by COVID-19, based on eligible providers’ net patient revenue. To expedite providers getting money as quickly as possible, HHS distributed $30 billion immediately, proportionate to providers’ share of Medicare fee-for-service reimbursements in 2019. Then, beginning on April 24, HHS began distributing an additional $20 billion to providers based on their share of net patient revenue, and began accepting submissions from eligible providers of their financial data. Providers have 45 days from the date they received a payment to attest and accept the Terms and Conditions or return the funds. Providers that do not log into the provider portal and accept the Terms and Conditions after 45 days of receipt will be deemed to have accepted the Terms and Conditions.

Other allocations have included $12 billion for hospitals in COVID-19 high-impact areas, $10 billion for rural providers, and $400 million for tribal healthcare providers. Some providers may receive further, separate funding, including skilled nursing facilities, dentists, and providers that solely take Medicaid. A portion of the Provider Relief Fund is being used to reimburse healthcare providers, generally at Medicare rates, for COVID-related treatment of the uninsured.

Visit hhs.gov/providerrelief for more information.

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FOR IMMEDIATE RELEASE
June 1, 2020

Harrisburg, PA – The Pennsylvania Department of Health today warned Pennsylvania’s Special Supplemental Nutrition Program for Women, Infants and Children (WIC) participants of potential scams and cautioned them not to disclose their personal information without verifying the identity of the caller.

Although WIC clinics do perform eligibility determinations, they will never call participants to request their bank account information to deposit funds directly into their accounts.

“The WIC program provides access to resources for mothers and children across Pennsylvania and we do not want our WIC participants worried about being taken advantage of – especially during the COVID-19 pandemic,” Sec. of Health Dr. Rachel Levine said. “We want participants to be alert, but know their information is protected and their benefits will continue to be distributed through secure means. Please be aware of potential scammers looking to steal personal information and report their number so more Pennsylvanians do not have this experience.”

If a WIC participant is unsure if a request for information is legitimate they should contact their local WIC office. Due to the COVID-19 pandemic, WIC services will be available over the phone or by virtual appointments until counties reopen into the green phase. Residents can find the address, hours of operation, and contact information for their local WIC clinic here.

Pennsylvanians should report scams to their local law enforcement or file a consumer complaint to the Office of the Attorney General through an online form, by calling 800-441-2555, or by email at [email protected].

The WIC program in Pennsylvania provides services at more than 260 locations and serves more than 205,000 pregnant women, infants and children under age 5. WIC families shop at more than 1,500 Pennsylvania grocery stores and spend $248 million a year with their WIC food benefits. In addition, the program also serves as a gateway for preventive health, and is considered one of the most successful, cost-effective and important nutrition intervention programs in the country.

For more information about WIC, visit www.pawic.com or call 1-800-WIC-WINS. The Pennsylvania WIC program is funded by the United States Department of Agriculture. This institution is an equal opportunity provider.

For information on how WIC clinics may be affected by COVID-19, please visit our fact sheet here.

The Wolf Administration stresses the role Pennsylvanians play in helping to reduce the spread of COVID-19:

  • Wash your hands with soap and water for at least 20 seconds or use hand sanitizer if soap and water are not available.
  • Cover any coughs or sneezes with your elbow, not your hands.
  • Clean surfaces frequently.
  • Stay home to avoid spreading COVID-19, especially if you are unwell.
  • If you must go out for a life-sustaining reason, please wear a mask.

Updated Coronavirus Links: Press Releases, State Lab Photos, Graphics

All Pennsylvania residents are encouraged to sign up for AlertPA, a text notification system for health, weather, and other important alerts like COVID-19 updates from commonwealth agencies. Residents can sign up online at www.ready.pa.gov/BeInformed/Signup-For-Alerts.

MEDIA CONTACT: Nate Wardle, 717-787-1783 or [email protected]

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The RCPA Telehealth Survey will close at end of day on Wednesday, June 3 as we begin our data review process. With your outcomes and feedback we will create an RCPA telehealth white paper position statement supporting our members’ utilization of telehealth on sustained platforms.

The data will also be a critical part of our ongoing efforts with DHS, the BH MCOs, and the work involved with telehealth implementation cross the Commonwealth.

To access the survey, please follow the link to the original RCPA Telehealth Survey Alert below:

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