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Tags Posts tagged with "OBRA Waiver"

OBRA Waiver

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The Office of Long-Term Living (OLTL) has released a message providing advance notice of the 2024 pre-administration of the home and community-based services (HCBS) Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey.

OLTL has the HCBS CAHPS survey administered to participants who receive HCBS through the Act 150 Program as well as the OBRA and the Community HealthChoices (CHC) Waiver Programs in the fall. The department then uses the responses received to assist them with improving the services participants receive. To increase response rates, OLTL is requesting Service Coordinators to begin having conversations with the HCBS participants in order to provide an introduction and encourage participation in the upcoming administration of the survey.

The HCBS CAHPS Survey will be administered from August 1, 2024, to October 31, 2024. This survey will ask questions about the services HCBS participants receive at home or in the community and how well the services meet their needs. Press Ganey, an independent firm, will conduct the survey. They will call participants to set up a time to talk. Member’s participants may also call Press Ganey toll free at 1-800-588-1659 (TTY: 711) if they would like to take the 30-minute survey. The number can also be used to make an appointment to take the survey at a time that works for them. Participants are randomly selected to participate in the survey from a list of all participants receiving HCBS through either the Act 150 Program, the OBRA Waiver, or the CHC Waiver Programs. Language Services can be provided to HCBS participants at no cost.

Members are encouraged to remind participants that their privacy is important. If they choose to participate, any information that they provide will be kept confidential. Participants will not be identified in any report that is released, and their answers will not be shared with their providers, Service Coordinator, or anyone else who assists them. It is the participant’s choice whether to participate, and their decision to participate will not affect any HCBS received through OLTL.

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The Office of Long-Term Living (OLTL) has announced two waiver amendments that are open for public comment. The amendments detail the Community HealthChoices (CHC) waiver renewal and the OBRA waiver amendments. Information on the CHC waiver and OBRA waiver are available individually as well as in the June 15, 2024, PA Bulletin. Comments are due July 15, 2024.

Those interested in submitting comments can do so in the following ways:

  1. For the CHC waiver:
    1. Send a letter to the Department of Human Services, Office of Long-Term Living, Bureau of Policy Development and Communications Management, Attention: Keeley Anglin—CHC Waiver Renewal, PO Box 8025, Harrisburg.
    2. Submit comments to the department via email. Use “CHC Waiver Renewal” in the subject line.
    3. Please use the CHC Waiver Comment Form.
  2. For the OBRA waiver:
    1. Send a letter to the Department of Human Services, Office of Long-Term Living, Bureau of Policy Development and Communications Management, Attention: Keeley Anglin—OBRA Waiver Amendment, PO Box 8025, Harrisburg.
    2. Submit comments to the department via email. Use “OBRA Waiver Amendment” as the subject line.
    3. Please use the OBRA Waiver Comment Form.

Comments received by July 15, 2024, will be considered in subsequent revisions to the proposed renewal and amendment. For more information, please contact Fady Sahhar or Melissa Dehoff.

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From June through August 2023, the Office of Long-Term Living (OLTL) held Listen and Learn Sessions across Pennsylvania. There were a total of sixteen in-person sessions and three virtual sessions where Community HealthChoices (CHC), OBRA, Act 150, and Living Independence for the Elderly (LIFE) participants, family members, and community members were able to offer input on how OLTL could improve its programs.

A summary of the input provided is now available and can be viewed here.

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Beginning in June 2023, the Office of Long-Term Living (OLTL) will hold Listen and Learn sessions with OLTL program participants across the Commonwealth.

OLTL provides Medical Assistance (MA) coverage and long-term services and supports (LTSS) to seniors and adults with physical disabilities through the Community HealthChoices (CHC), OBRA, Act 150, and Living Independence for the Elderly (LIFE) programs. The office wants to hear from participants who receive services through one of these programs and will be holding Listen and Learn Sessions at the locations and times listed here. These sessions are intended for OLTL staff to hear directly from participants, advocates, and community partners, with the goal of gathering critical feedback on OLTL programs.

Members are encouraged to share this information with their clients and families so they can attend and give their feedback on OLTL programs. Some sessions will be held in-person, and some will be conducted virtually. Space may be limited, so attendees are encouraged to register as soon as possible.

Questions about these sessions should be directed to the OLTL Provider Helpline at 800-932-0939.

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The Office of Long-Term Living (OLTL) has released the transition plans that outline how the Appendix K flexibilities will be phased out on May 11, 2023, with the end of the Public Health Emergency. The transition plans apply to the Community HealthChoices (CHC) Waiver, OBRA Waiver, and Act 150 program.

Since March 6, 2020, the Office of Long-Term Living (OLTL) has been operating under an Appendix K Emergency Preparedness and Response amendment that was approved by the Centers for Medicare & Medicaid Services (CMS). Appendix K allowed temporary changes to the CHC Waiver, OBRA waiver, and Act 150 waiver in response to the COVID-19 Public Health Emergency.

Effective May 11, 2023, OLTL is discontinuing the emergency flexibilities noted in the attached guidance and is returning to pre-emergency operations. Providers should make any changes that are necessary to resume normal operations and be in compliance by May 11, 2023. Service Coordinators have been instructed to work with participants and providers to ensure a seamless transition to normal operations.

The transition plans have been updated to reflect the new expiration date for the flexibilities. In addition, as a general note, resuming pre-emergency waiver operations means the following:

  • All assessments, including the comprehensive needs assessments and reassessments, must be conducted face-to-face;
  • Service Coordinators must monitor participants and Individual Services Plans (ISPs) through face-to-face contacts; and
  • ISP meetings and development must be conducted face-to-face.

Questions about this information should be directed to the OLTL Provider Helpline at 800-932-0939.

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The Centers for Medicare and Medicaid Services (CMS) has approved the Office of Long-Term Living’s (OLTL) OBRA Waiver Amendment. Changes in the approved OBRA Waiver Amendment include:

  • Revised the Benefits Counseling service definition;
  • Amended the responsibilities of the Fiscal/Employer Agent;
  • Updated Appendix H Quality Improvement Strategy to the current process; and
  • Removed performance measure AA-6, as the data in AA-6 is being collected by AA-5.

The current approved OBRA Waiver document can be viewed here. If you have any questions, please contact the OLTL Bureau of Policy Development and Communications Management at (717) 857-3280.

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A Financial Management Services (FMS) stakeholder meeting has been scheduled for January 6, 2023, from 1:00 pm – 2:30 pm. During this public meeting, there be a discussion on the administration of FMS under the Community HealthChoices (CHC), OBRA Waiver, and Act 150 programs. Representatives from the Office of Long-Term Living (OLTL) and CHC Managed Care Organizations (MCOs) will be in attendance to discuss the FMS program.

Please register using this registration link. After registering, you will receive a confirmation email containing information about joining the webinar.

If you choose to use your phone to call in, please use the numbers below:
Dial in: (631) 992-3221
Access Code: 335417876#
Audio PIN: shown after joining the webinar

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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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The Office of Long-Term Living (OLTL) will conduct a Financial Management Services (FMS) stakeholder webinar on October 7, 2022, from 1:00 pm – 2:30 pm. This public meeting will be to discuss upcoming changes for the administration of FMS under the Community HealthChoices (CHC), OBRA Waiver, and Act 150 programs. Representatives from the Office of Long-Term Living (OLTL) and CHC Managed Care Organizations will be in attendance to discuss upcoming changes. Registration is required to participate in the webinar. After registering, you will receive a confirmation email containing information about joining the webinar.

If you choose to use your phone to call in, please use the numbers below:

Dial in: (631) 992-3221
Access Code: 988871316#
Audio PIN: shown after joining the webinar

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The next Financial Management Services (FMS) stakeholder meeting is scheduled for Friday, September 2, 2022, from 1:00 pm – 2:30 pm. The purpose of this meeting is to discuss the upcoming changes for the administration of FMS under the Community HealthChoices (CHC), OBRA Waiver, and Act 150 programs. Representatives from the Office of Long-Term Living (OLTL) and CHC Managed Care Organizations (MCOs) will be in attendance to discuss upcoming changes.

Please register using this registration link. After registering, you will receive a confirmation containing information about joining the webinar.

If you choose to use your phone to call in, please use the numbers below:
Dial in: 562-247-8422
Access Code: 834499387#
Audio PIN: shown after joining the webinar

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