PHE
SB 1019: DHS Regulatory Review of COVID-19 Flexibilities
CMS Issues RFI on Prior Authorization for Hospital Transfers to PAC Settings During PHE
In today’s Federal Register, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule that included updates to the Medicare Advantage program. Contained within this proposed rule is a Request for Information (RFI): Prior Authorization for Hospital Transfers to Post-Acute Care (PAC) Settings During a Public Health Emergency (PHE). The RFI highlights several concerns, including the fact that providers often wait up to three days for authorization determinations, and that a high rate of MA requests are initially denied, all of which hinder the ability of hospitals to maximize capacity during a public health emergency (PHE). The RFI requests several areas for feedback, including the overall impact of prior authorization on hospitals and patient care, the denial rates and associated burden on providers, and the consequences of delayed patient transfers.
Members are encouraged to share any direct examples of these prior authorization issues with Melissa Dehoff, Director, Rehabilitation Services Division. In addition, this issue will be discussed during the upcoming Outpatient Rehabilitation Committee and Medical Rehabilitation Committee meetings.
Resources for ODP Providers Regarding COVID Protocols
Resources for ODP Providers Regarding COVID Protocols and Updated Public Health Policies
Message from the Office of Developmental Programs (ODP):
The Office of Developmental Programs (ODP) distributed the 2021 Health Alert: COVID-19 Safety and Treatment Reminders. This document provides updated guidance and recommendations on procedures in dealing with Coronavirus 2019 (COVID-19) exposure, infection, quarantine, isolation, and treatment. The PA Department of Health also recently released PA HAN 613 – COVID-19 Treatment Options and the referenced PA HAN 575 – COVID-19 Treatment Options to update the field regarding treatment options.
In the event that infections occur, ODP would also like to remind you that treatment options exist. Speak with your health care provider about treatment if you or someone you support has been diagnosed with COVID-19. If you have questions about this guidance, please call your local health department or 877-PA-HEALTH (877-724-3258).
- For the most up-to-date information on COVID-19 monoclonal antibody treatment changes, visit here.
- Clinicians with questions about approved treatments and those with EUAs issued by the FDA may refer to the reference NIH web page.
- PA DOH provides information on the Prevention and Treatment of COVID-19, which includes information on how to get treatment for COVID-19. You can find locations for COVID-19 treatments at Therapeutics Distribution | HHS Protect Public Data Hub.
ODP recognizes and thanks you for all that you have done and continue to do for the protection of the individuals you support, your staff, and the families of both.
SAMHSA Extends Methadone Take-Home Flexibility
The Substance Abuse and Mental Health Services Administration (SAMHSA) is extending the methadone take-home flexibilities for one year, effective upon the eventual expiration of the COVID-19 Public Health Emergency (PHE). This exemption is a continuation of the take-home medication flexibilities that SAMHSA put in place in March 2020 and is in keeping with the newly announced Health and Human Services (HHS) Overdose Prevention Strategy. SAMHSA is also considering mechanisms to make this flexibility permanent. Visit here for more information.
Continuation of the Appendix K Temporary Changes to the CHC Waiver, OBRA Waiver, and Act 150 Program
Message from the Office of Long-Term Living (OLTL):
This communication is a reminder that the Office of Long-Term Living (OLTL) is allowed to continue available temporary changes to the CHC waiver, OBRA waiver, and the Act 150 Program under Appendix K, Emergency Preparedness and Response, until six months after the end of the federal public health emergency related to COVID-19.
On October 15, 2021, the federal public health emergency was extended by 90 days; however, it’s possible the federal government will decide to extend the emergency further. Please visit this public health emergency website to see the current and future public health emergency declarations related to COVID-19. OLTL will issue guidance in the future when the Appendix K flexibilities are closer to expiring.
For further information on the available OLTL Appendix K flexibilities, please visit the OLTL Resources page. If you have questions about the information, please contact the OLTL Provider Helpline at 1-800-932-0939.
State Associations Submit Requests Regarding COVID-19 Public Health Emergency
ANCOR Update on Public Health Emergency Extension and FMAP Increases
HHS Renews COVID-19 Public Health Emergency
The Department of Health and Human Services (HHS) Secretary Xavier Becerra has again issued the renewal of the COVID-19 public health emergency (PHE) due to the continued consequences of the COVID-19 pandemic. The renewal became effective on October 18, 2021 and will extend the PHE into early 2022. This PHE status enables the Centers for Medicare and Medicaid Services (CMS) to keep all applicable waivers in place.
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