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Physical Disabilities & Aging

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The Centers for Medicare and Medicaid Services (CMS) has released a new Frequently Asked Question (FAQ) document that addresses how their review contractors (Medicare Administrative Contractors, Recovery Audit Contractors, and the Supplemental Medical Review Contractor) will conduct medical reviews after the COVID-19 public health emergency (PHE). Read the FAQ here.

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Date: November 16, 2022
Time: 1:30 pm – 3:00 pm EST

The Medicaid Home and Community-Based Services (HCBS) Settings Final Rule was made effective on March 17, 2014. The settings rule set specific requirements for settings presumed to have institutional characteristics, including settings in institutions, settings on the grounds of or adjacent to a public institution, and settings that have qualities that isolate Medicaid beneficiaries. Referred to as “presumptively institutional settings,” states are required to assess these settings and, where the state has determined that the setting overcomes the institutional presumption and the setting complies or will comply with the settings rule by March 17, 2023, submit to CMS documentation that demonstrates the setting’s compliance. CMS has launched a series of heightened scrutiny site visits to presumptively institutional settings in states. This training will cover:

  • An overview of CMS’ heightened scrutiny site visit process;
  • Overarching themes identified during CMS’ heightened scrutiny site visits; and
  • Considerations for states moving forward.

Following the presentation, webinar participants will have the opportunity to share any questions, comments, experiences, or suggestions with CMS and the presenter.

Please register for this webinar here.
Conference Line: 844-875-7777; Access Code: 715810#

Please note that closed captioning will be provided.

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The Department of Human Services (DHS) published a notice in the Pennsylvania Bulletin for November 12, 2022, that announces revisions to the Medical Assistance (MA) fee schedule for the OBRA Waiver and the Act 150 Program: Personal Assistance Services (PAS) (Agency with Choice) and Respite (Agency with Choice).

DHS proposes the following substantive and technical changes to the OBRA Waiver:

  • Add Agency with Choice as a Financial Management Services model for the participant-directed services of PAS and Respite;
  • Revise the Benefits Counseling service definition;
  • Amend the responsibilities of the Fiscal/Employer Agent;
  • Update the Quality Improvement Strategy to the current process;
  • Add a new performance measure for Agency with Choice; and
  • Remove a performance measure that is duplicative.

The proposed OBRA Waiver amendment and a summary of all revisions are available for review on the OLTL Waiver Amendments, Renewals, and Accompanying HCBS Transition Plans web page under Additional Resources.

The following table provides the procedure code and rates for PAS (Agency with Choice):

Region OBRA Waiver
and Act 150		 Procedure Code Modifier Rate Unit
1 X W0164 N/A $4.02 15 minutes
2 X W0164 N/A $3.89 15 minutes
3 X W0164 N/A $4.12 15 minutes
4 X W0164 N/A $4.58 15 minutes

The following table provides the procedure code and rates for Respite (Agency with Choice):

Region OBRA Waiver
and Act 150		 Procedure Code Modifier Rate Unit
1 X W0165 N/A $4 15 minutes
2 X W0165 N/A $3.90 15 minutes
3 X W0165 N/A $4.12 15 minutes
4 X W0165 N/A $4.59 15 minutes

Interested persons are invited to submit written comments regarding these fee schedule rates and the proposed amendment to the Department of Human Services, Office of Long-Term Living, Bureau of Policy Development and Communications Management, Attention: Robyn Kokus, P.O. Box 8025, Harrisburg, PA 17105-8025. Comments can also be sent via email. Use ”OBRA 2023” as the subject line. Comments received within 30 days will be considered in subsequent revisions to the fee schedule or for revisions to the proposed amendment.

The revisions to the fee schedule and the amendment are proposed to take effect April 1, 2023.

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Image by Werner Moser from Pixabay

The Department of Human Services’ (DHS) Office of Long-Term Living (OLTL) published the proposed amendment to the Community HealthChoices (CHC) Waiver in the Pennsylvania Bulletin for November 12, 2022.

DHS and OLTL are proposing to amend the CHC Waiver by adding Agency with Choice as a Financial Management Services (FMS) model for the participant-directed services of Personal Assistance Services (PAS) and Respite. This would modify Service Coordinator and Service Coordinator Supervisor qualifications to align with the CHC Agreement and to amend the service definitions for the following CHC waiver services:

  • Benefits Counseling;
  • Nursing Services;
  • Physical Therapy Services;
  • Occupational Therapy Services; and
  • Speech and Language Therapy Services.

Also proposed is a technical change to the waiver by revising performance measures.

The proposed CHC waiver amendment and summary of all revisions are available for review on the OLTL Waiver Amendments, Renewals, and Accompanying HCBS Transition Plans web page under Additional Resources.

Interested persons are invited to submit written comments regarding the proposed waiver amendment to the Department of Human Services, Office of Long-Term Living, Bureau of Policy Development and Communications Management, Attention: CHC 2023 Waiver Amendment, P.O. Box 8025, Harrisburg, PA 17105-8025. Comments may also be submitted to the Department via email. Use ”CHC 2023 Waiver Amendment” as the subject line. Comments received within 30 days of publication of this notice will be reviewed and considered for revisions to the proposed waiver amendment.

The proposed amendment will be effective April 1, 2023.

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Webinar
Sponsored by Streamline Healthcare Solutions, featuring Microsoft

Why EHR Infrastructure Matters: Streamline and Microsoft Discuss How Different Hosting & Deployment Options Impact Performance, Security, and Cost

Behavioral Health and Human Services organizations have a choice of hosting and deployment options when selecting an Electronic Health Record (EHR) system, and which option they choose has a significant impact on performance, security, and cost. Join executives from Streamline Healthcare Solutions and Microsoft as they discuss the most common hosting and deployment options, including the SaaS model, single-tenant vs multi-tenant architecture, and cloud hosting.

Speakers:
Andy Pitman U.S. Director, Health and Human Services, Microsoft
Matt Chamberlain EVP of Sales and Marketing, Streamline Healthcare Solutions
Javed Husain, Co-Founder & CEO, Streamline Healthcare Solutions
Solome Tibebu, Founder & CEO, Going Digital: Behavioral Health Tech

Webinar Date: Wednesday, November 30, 2022
Time: 12:00 pm – 1:00 pm CT
REGISTER HERE

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First Nonprofit

Are You Leaving Employee Retention Tax Refund Money on the Table?
Your nonprofit may be eligible for up to $26,000 per employee, paid in the form of a refund by the IRS, if you had to partially or fully suspend operations due to government orders OR experienced a significant revenue decrease during the COVID-19 pandemic. RCPA has partnered with First Nonprofit to provide our members with an opportunity to determine if you are eligible and, if so, provide a reputable, vetted, and affordable service to assist you in filing. Take this five-question survey to find out if you are eligible.

Use this link for information about the Nonprofit Employee Retention Tax Refund.

Contact Cheryl Jones with any additional questions:
cjones@firstonprofit.com
612-308-4283

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