The Office of Long-Term Living (OLTL) recently announced that the waiver amendments effective as of October 1, 2017 have been posted to the Department of Human Services (DHS) website. The waivers and links to each one include:
Questions related to this communication may be directed to the OLTL Bureau of Policy and Regulatory Management at 717-783-8412.
As the implementation of Community HealthChoices (CHC) approaches the January 1, 2018 launch in the Southwest Region, the Department of Human Services (DHS) has developed informational materials for those individuals who will be covered by the new program. The documents, including notices and the pre-enrollment packet, are posted on the DHS website, where you will also find their most recent participant document, “CHC: Here’s What You Need to Know” (available for download in English and Spanish).
In addition, a document designed to clarify eligibility for CHC is available here. It includes the following information:
Individuals are NOT eligible for CHC if they are a person with an intellectual or developmental disability who is eligible for services through the Department of Human Services’ Office of Developmental Programs (ODP), OR are a resident in a state-operated nursing facility, including state veterans homes.
Please visit the CHC website or call the CHC Provider Hotline at 833-735-4417 with any questions.
The Department of Human Services (DHS) recently issued the following information and resources in preparation for the roll-out of Community HealthChoices (CHC) beginning January 2018 in the Southwest zone of the state.
The Department of Human Services (DHS) is committed to open and frequent communication to educate and inform individuals who will move to Community HealthChoices (CHC). It is critical that they are aware of the upcoming changes and are able to make an informed decision on their plan selection. We are using multiple channels to get the message out, and want to ensure that you are aware of upcoming information that potential participants will receive.
Participants in the Southwest Zone received this flyer (also available in Spanish) in August 2017 to inform them that CHC was coming to their county in January 2018.
Participants in the Southwest will receive an invitation to community meetings in late September.
There will be more than 40 events in the Southwest Zone, with at least one in each of the 14 impacted counties. The meetings will give more information about CHC, the LIFE program, and answer questions participants may have.
To register for a community meeting, participants can go to www.healthchoices.pa.gov or call 1-833-735-4416. A copy of the invitation is available here.
DHS will mail notices to potential participants beginning today. The notice will inform participants that they will transition to CHC in January and will need to select a health plan, also called a managed care organization (MCO).
The notice also tells potentially eligible participants that they may be eligible for the LIFE program.
Copies of the notices are be available here.
Beginning on October 2, 2017, pre-enrollment packets will be mailed to participants. This packet will contain information about each of the health plans and the benefits offered by each plan, and tell participants how to enroll in a health plan. There will be a toll-free number and website for participants to use to make their selection. A day after the packets are mailed, automated calls will be made to let participants know that the packets are coming.
If participants do not select a health plan, they will get a follow-up call.
Individuals who do not select a plan by November 13, 2017, will be assigned to a plan. Individuals can change their plan at any time.
DHS’ Facebook, Twitter, and YouTube accounts make CHC information readily available. If you are not following us yet, please click the provided links to make sure you are receiving all up-to-date information on CHC and all department priorities.
(Map, Community HealthChoices Phases)
The Department of Human Services (DHS) published a notice that will appear in tomorrow’s Pennsylvania Bulletin that they intend to make a supplemental payment in fiscal year (FY) 2017/2018 to certain special rehabilitation facilities (SRFs) that have high Medical Assistance (MA) and total facility occupancy levels. An SRF is one that specializes in providing services and care to adults who have a neurological/neuromuscular diagnosis and condition, as well as severe functional limitations. Because of the complex needs of these individuals, SRF’s typically incur staffing and specialized medical equipment costs that are very high. Additionally, SRF’s with high MA and total facility occupancy levels are dependent on MA payments to continue to operate. To help offset the higher costs incurred by these SRFs while they reconfigure to home and community-based services, DHS intends to make a supplemental payment to these facilities to assure that the unique services they provide continue to be available to MA beneficiaries.
To qualify for an MA dependency payment the following requirements must be met:
DHS will accept comments on this notice for thirty days following publication. Comments should be sent to: Department of Human Services, Office of Long-Term Living, Bureau of Policy and Regulatory Management, Attention: Marilyn Yocum, PO Box 8025, Harrisburg, PA 17105-8025.
The Department of Human Services (Department) is soliciting public input on the use of electronic visit verification (EVV) systems for Medicaid-funded personal care and home health care services in Pennsylvania. See announcement below and here.
In the May 13, 2017 PA Bulletin, the Department of Human Services (Department) made available for public review and comment the Medical Assistance Quality Strategy for Pennsylvania.
The Department is complying with Centers for Medicare and Medicaid Services’ (CMS) requirement that states draft and implement a written quality strategy for assessing and improving the quality of health care and services furnished by managed care organizations that have a contract with the Department. As a result, the Department has developed the Medical Assistance Quality Strategy for Pennsylvania, which discusses the various quality improvement initiatives the Department has implemented to increase the quality of care for individuals receiving services through its managed care programs. The Medical Assistance Quality Strategy for Pennsylvania is not intended to comprehensively describe all the activities that the Department undertakes to assure the quality of care rendered to individuals who are receiving services through managed care programs.
The Department’s quality strategy will be used to assure that the contractors that are implementing the Department’s managed care programs are in compliance with the terms of their agreements with the Department and have committed resources to meet the following: to perform monitoring and ongoing quality improvement; to contribute to the improvement of health for the populations they serve; and to incorporate new programmatic changes to assure that the individuals they serve have timely access to high-quality care.
The Medical Assistance Quality Strategy for Pennsylvania will include programs and initiatives within the following:
The Medical Assistance Quality Strategy for Pennsylvania can be viewed here and interested persons are invited to submit comments regarding the Medical Assistance Quality Strategy for Pennsylvania to the Department via email. Comments received within 30 days must be reviewed and considered before the Quality Strategy is submitted to CMS for review.
Persons with a disability who require an auxiliary aid or service may submit comments using the Pennsylvania AT&T Relay Service at 800-654-5984 (TDD users) or 800-654-5988 (voice users).
The Department of Human Services (DHS) is announcing two changes to the planned effective dates of the new Physical HealthChoices agreements originally planned for June 2017. View the full release for details.
On February 8, the Department of Human Services (DHS) Secretary Ted Dallas announced the availability of onboarding grant funds to help connect hospitals and ambulatory practices to the Authority’s Pennsylvania Patient & Provider Network, or P3N.
The P3N enables electronic health information exchange (eHIE) across the state through the connection of health care providers to health information organizations (HIO), and the participation of the HIOs in the P3N.
“These grants will assist providers in the efficient delivery of quality services to the individuals we serve across the commonwealth,” said DHS Secretary Ted Dallas. “As more providers participate, individuals will experience better coordination of care and a better quality of health care.”
The grant program, available to Pennsylvania HIOs to enable the connection of inpatient hospital/facilities and outpatient practice or other outpatient provider organizations participating in the Medicaid Electronic Health Records (EHR) Incentive Program, includes:
Each eligible provider will connect via an HIO to the P3N.
Only a single award is permitted to any one hospital/facility or outpatient practice. The anticipated performance period for this grant runs through September 30, 2017.
The grant will:
This program will be made possible through an $8.125 million grant from the federal Centers of Medicare & Medicaid Services (CMS). Under the terms of the federal grant, CMS will provide 90 percent of the onboarding grant, with the remaining 10 percent funded by the Commonwealth. The grant applications and supporting materials are available online here.
(Information courtesy of DHS)
The Department of Human Services (DHS) has announced the recent changes to the OBRA Waiver that have been approved by the Centers for Medicare and Medicaid Services (CMS). Some of the waiver amendments include:
The complete service definitions and requirements are now included in an updated OBRA Waiver document. The effective date of these changes is February 1, 2017.
The OBRA Waiver PROPOSED rates for the new Employment Services have also been released. Questions regarding these rates should be directed to (717) 783-8412.
Prev