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Tags Posts tagged with "Compliance"

Compliance

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The PA Office of Medical Assistance Programs (OMAP) issued a new Bulletin that applies to personal assistance and community habilitation services under the Office of Long-Term Living (OLTL) and the Office of Developmental Programs (ODP). The key changes from earlier guidance include:

  • Providers 85% Compliance Requirement Effective January 1, 2025: Providers must ensure at least 85% of EVV records are verified without manual edits.
  • Starting January 2026, DHS will issue alerts to fee-for-service providers whose manual edits exceed 15% in the prior quarter. Managed care organizations (MCO) will also receive lists of noncompliant providers for follow-up.
  • Providers failing to meet the 85% thresholds for two consecutive quarters will be required to submit corrective action plans. Continued noncompliance may lead to sanctions, potentially including loss of license.
  • FMS and Participant-Directed Models are also responsible for EVV compliance. Persistent noncompliance can result in termination from participant-directed service models.
  • Additional Resources: DHS EVV Guidance and Handbook now available.
  • Compliance Reports are available on the Sandata platform. The reports allow providers to identify the non-compliant visit dates, participants, and caregivers to initiate internal corrective action.

If you have any questions, contact Fady Sahhar.

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RCPA Partner Eleos knows how to throw a party, and their virtual event next month is no exception. Join them for the debut of Eleos Compliance at their Winter 2025 Launch Event. 

This 1-hour virtual event will kick off with a product launch video, then AI experts and real-life Eleos customers will present New Year, New AI Advancements with Eleos Documentation and Compliance.

Eleos Compliance is a new AI-powered solution that enables behavioral health CDI and CQI teams to continually scan 100% of notes for six of the most common compliance red flags. By quickly identifying high risk areas, there’s more time to spend on staff education and training to prevent further issues. 

Register now to join them on February 19 at 12:00 pm Eastern, when Alon Joffe, Eleos Co-founder and CEO, will be joined by Eleos’ customers Rony Gadiwalla, CIO at GRAND Mental Health, and Tom Morgan, CIO at Merakey, to:

  • Define and explain the riskiest note compliance issues in behavioral health.
  • Detail how the NEW Eleos Compliance product — in conjunction with the new Eleos Documentation Dashboard — helps organizations proactively monitor, manage, and prevent documentation quality issues.
  • Showcase the measurable impact of AI-driven compliance and documentation technology at GRAND Mental Health.

It’s a great opportunity to get familiar with all the operational benefits specialized AI has to offer — and to discover why Eleos is the behavioral health technology providers (and leaders) actually love. 

Stay tuned for their next launch event in Q2!

Register for this exciting event now. If you can’t make it to the live event, you’ll receive an on-demand recording afterwards.

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The U.S. Department of Labor’s Wage and Hour Division will offer compliance seminars for contracting agencies, contractors, unions, workers, and other stakeholders on the requirements for paying prevailing wages on federally funded construction and service contracts. Part of the division’s effort to increase awareness and improve compliance, each day-long seminar will include sessions on the Davis-Bacon Act, Service Contract Act, and other related topics. Participants can choose among the sessions offered throughout the day.

The seminars are scheduled on Feb. 27, May 15, and Aug. 29.

Register today. While seminar attendance is free, registration is required. Additional details, including links to the sessions for each date, will be provided to participants after registration.

For additional information on prevailing wage compliance, the division also has an updated video library on the Davis-Bacon and Related Acts, the Service Contract Act, and various executive orders.

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