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odp announcement

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ODP Announcement 22-030 shares that the proposed amendment to the Adult Autism Waiver (AAW) is available for public review and comment. There is a 30-day public comment period that starts on March 12, 2022, and ends on April 11, 2022.

The Office of Developmental Programs (ODP) is seeking your valuable feedback and comments. Information regarding the proposed waiver amendment changes, including how to provide comments, can be found in the Pennsylvania Bulletin, Volume 52, Number 11, which was published on Saturday, March 12, 2022. The waiver amendment and the record of change document are available here.

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ODP Announcement 22-029 serves to announce an opportunity for providers to have a staff person(s) participate in a virtual certification program with the goal of receiving a Work Incentives Practitioner credential.

Please complete an application for the Office of Developmental Programs (ODP) to get to know your organization and to measure your interest and commitment in having a staff person(s) receive the Work Incentives Practitioner credential and enrolling with ODP to provide the Benefits Counseling service. Applications must be submitted by email to Laura Cipriani no later than April 1, 2022.

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ODP Announcement 22-025 is to inform individuals that the Office of Developmental Programs (ODP) updated the data used in establishing rates that impacted the hourly wage and benefits rages effective March 1, 2022.

While the rate setting process resulted in minor decreases to the Upper Bound of the Hourly Wage and Benefits Ranges for several services in Attachment #1, ODP has decided to continue the Upper Bound at the levels that were in effect prior to March 1, 2022, for those services. The Hourly Wage and Benefits Ranges in Attachment #1 have been updated and should be used to pay SSPs and to support claims processing in the Provider Reimbursement and Operations Management Information System in electronic format (PROMISe™) by the VF/EA FMS organization.

This communication will only be updated when changes occur to the information contained within.

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ODP Announcement 22-021 provides guidance on the upcoming rate increases for the Adult Autism Waiver. Compensation is beginning March 1, 2022; the new rates will be implemented in the Home and Community Services Information System (HCSIS) on March 1, 2022. All Individual Support Plans (ISPs), including ISPs in draft, pending review, or pending approval status, will be updated with the new rates for each of the applicable services. An additional fiscal segment will automatically be added on each ISP for each service that is impacted by the rate change.

Providers are strongly encouraged to review Service Authorization Notices or the Provider Service Detail report in HCSIS to confirm the new rates were loaded, authorized, and that they are billing the increased Fee Schedule Rate before attempting to bill for any services rendered March 1, 2022, and after.

Compensation for the Period July 1, 2021, through February 28, 2022

Providers should bill normally for any services rendered from July 1, 2021, through February 28, 2022. ODP will be compensating providers, via gross adjustments, for the difference between the rate billed and the updated fee schedule rate for dates of service rendered during the period July 1, 2021, through February 28, 2022. This is intended to eliminate the provider’s effort of voiding and re-billing claims.

ODP anticipates processing gross adjustments during the April to May 2022 timeframe to ensure all billing for dates of service July 1, 2021, through February 28, 2022, has been completed. Because the rates will be loaded into HCSIS effective July 1, 2021, and the gross adjustment compensation will be issued by ODP, providers should not adjust any claims after April 1, 2022, submitted for services rendered on July 1, 2021, through February 28, 2022.

Adjustment of a claim(s) for services delivered during these dates will result in a duplication of payment that will need to be repaid. Providers are strongly encouraged to bill in a timely manner to minimize the need for corrections.

For questions on how to resolve billing errors for services that were rendered on July 1, 2021, through February 28, 2022, contact Amber Bennett.

Correction to Rates for Small Group Employment and Residential Habilitation Ineligible Fees

Because of an internal editing error, the rates for Small Group Employment and Residential Habilitation: Community Home Ineligible published in the Pennsylvania Bulletin (52 Pa.B. 1326, February 26, 2022) were incorrect. The correct rates, with the corresponding procedure codes, are higher than what was published. The corrected rates are also available on the Department of Human Services’ website.

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ODP Announcement 22-028 is to notify licensees that trainings in First Aid, Heimlich techniques, and/or CPR provided to staff and caregivers in ODP-licensed settings on or after April 1, 2022, must have an in-person component.

During the height of the COVID-19 pandemic, ODP permitted online-only courses with no in-person component, as many hospitals and health care organizations were not offering in-person classes. Hospitals and health care organizations have since resumed in-person instruction with necessary COVID precautions in place. As such, any training in First Aid, Heimlich techniques, and/or CPR provided to staff and caregivers in ODP-licensed settings on or after April 1, 2022, must have an in-person component.

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ODP Announcement 22-027 states that the Temple University Harrisburg Certified Investigator Program and the Office of Developmental Programs (ODP) will be facilitating Forums for Certified Investigators (CIs) and others involved in the incident investigation process. It also announces the posting of Q&A documents from past CI Forums on MyODP.

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ODP Announcement 22-025 serves to provide the hourly wage and benefits ranges for specific Participant Directed Services (PDS) for participants utilizing the Vendor Fiscal/Employer Agent (VF/EA) FMS model, effective March 1, 2022. The Office of Developmental Programs (ODP) updated the data used in establishing rates, which impacted the hourly wage and benefits ranges. The high end of the hourly wage and benefits ranges either increased or remained the same. There were no decreases to the high end of the hourly wage and benefits ranges. These wage and benefit ranges will be used to pay SSPs and to support claims processing in the Provider Reimbursement and Operations Management Information System in electronic format (PROMISe™) by the VF/EA FMS organization. This communication will only be updated when changes occur to the information contained within.

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ODP Announcement 22-026 is to announce that the proposed Fee Schedule Rates and Department-Established Fees for Consolidated, Community Living and P/FDS Waiver services, as well as the Community Intellectual Disability Base-funded program were published at 52 Pa.B. 102 (January 1, 2022).

The Department received comments from 134 stakeholders regarding the proposed changes to the Fee Schedule Rates and Department-Established Fees. After reviewing the comments on the proposed rates, the Department determined that an increase to the Fee Schedule Rates for the Agency With Choice Financial Management Services monthly administrative fee from $285.28 to $311.68 was necessary to cover staff wages and the costs of implementing participant directed services in accordance with requirements in the approved Waivers.

No other changes were made to the rates as a result of public comment.

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ODP Announcement 22-024 is intended to provide the hourly wage and benefits ranges for specific Participant Directed Services (PDS) provided to participants utilizing the AWC FMS model, effective March 1, 2022.

ODP updated the data used in establishing rates, which impacted the hourly wage and benefits ranges effective March 1, 2022. The high end of the hourly wage and benefits ranges either increased or remained the same.

These wage and benefit ranges will be used to pay SSPs and to support claims processing in the Provider Reimbursement and Operations Management Information System (PROMISe™) in electronic format by the AWC FMS organization. This communication will only be updated when changes occur to the information contained within.

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