';
CLOSE
Tags Posts tagged with "Waiver Amendment"

Waiver Amendment

0 374

The Office of Developmental Programs (ODP) met with stakeholders today, October 30, 2024, to discuss waiver amendments and to provide an overview of Performance-Based Contracting.

Waiver Amendments included:

Waiver Capacity:

  • When an individual is in an acute care hospital and receiving waiver services, ODP will not need to reserve (hold) the individual’s waiver. They will maintain enrollment in the waiver.
  • Language was updated for waiver capacity for high school graduates in the P/FDS waiver. AEs can reserve the waiver capacity for 180 days prior to when services are needed. Students can remain in service until their 22nd birthday.

Assistive Technology:

  • Updated language to explain when an independent evaluation is required and when it is optional:
    • REQUIRED: A device will cost $750 or more.
    • OPTIONAL: A device will cost less than $750.
  • An independent evaluation can be done if the team decides it would be beneficial.
  • Evaluations are included in the $10,000 lifetime limit.

Community Participation Support:

  • The Community Participation Support provider must complete and update an analysis of the following at least yearly to support individuals to experience meaningful community inclusion:
    • Strongest interests and personal preferences for community activities;
    • Skills, strengths, and other contributions likely to be valuable to employers or the community; and
    • Conditions necessary for successful community inclusion and/or competitive integrated employment.

American Sign Language (ASL) – English Interpreter Service:

  • English Interpreter service will be added to ODP’s waivers effective January 1, 2025.

Music, Art, & Equine Assisted Therapy:

  • The cumulative maximum limit of any combination of Music Therapy, Art Therapy, or Equine Assisted Therapy has increased from 26 to 52 hours per fiscal year.

STAT Overview:

  • The Specialty Telehealth and Assessment Team service was implemented in March 2024. This service may also be delivered to the participant during temporary travel, per ODP’s travel policy.

Waiver Corrections:
Life Sharing:

  • The following may not be authorized for participants who receive Life Sharing services: Residential Habilitation; Supported Living; Respite (15-minute or Day) (has been removed).

Supported Living Corrections:

  • The following services may not be authorized for participants who receive Supported Living services: Life Sharing; Residential Habilitation; Respite (15-minute or Day); Homemaker/Chore; In-Home and Community Supports; Behavioral Supports; Therapies; Shift Nursing; Consultative Nutritional Services; Communication Specialist and Specialize.

Benefits Counseling:

  • New billable indirect activities are added. The limit has increased from 15 hours per fiscal year to 24 hours per fiscal year.

The Performance-Based Contracting Review Included:

  • Effective January 1, 2025, Performance-Based Contracting will be implemented for the following services funded through the Consolidated and Community Living Waivers:
    •  Residential Habilitation;
    •  Life Sharing; and
    •  Supported Living.
  • Changes to Enrollment of New Providers.
  • What are Performance Standards?
  • What are Provider Tiers?
  • What Do These Changes Mean to Individuals and Families?

All performance-based contracting questions can be sent electronically.

Please see the distributed PowerPoint for additional information.

0 241

Intellectual Disability/Autism (ID/A) Waiver Amendments Effective January 1, 2025

Audience: All Stakeholders
Date: October 30, 2024, 11:00 am – 12:00 pm
Register Here

The Centers for Medicare and Medicaid Services (CMS) approved amendments to the Consolidated, Community Living, and Person/Family Directed Support Waivers (ID/A Waivers) effective January 1, 2025. This webinar will provide a general overview of the changes made in the ID/A waivers. There will be time during the session for presenters to answer questions submitted by participants during the webinar.

0 525

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.

0 622

As described in ODPANN 24-041, providers were to request the subject payments no later than May 15. As of June 4, 2024, the Office of Developmental Programs (ODP) has processed the subject payments for all providers who have applied. These payments should be visible on the provider’s Remittance Advice on June 17, 2024, at the highest billing service location.

0 565

RCPA has gathered feedback from our members in multiple forums and attended several listening sessions hosted by the Office of Developmental Programs (ODP) in order to hear and compile public comments on the proposed implementation of performance-based contracting (PBC) for Residential Services and waiver amendments to the Consolidated, Community Living, and Person/Family Directed Waivers. After reviewing all of the available information, we have submitted our comments to ODP.

Our members support the ideal of assuring quality services for individuals with ID/A that are integrated and person centered, enabling individuals to experience more independence and choices in their lives. Additionally, we are in favor of limiting the provider pool to only those providers that are able to demonstrate quality service provision.

RCPA wants to support this program for two reasons. First, any initiative by ODP that focuses on improving quality in the system is something we all should stand behind. Second, alternative reimbursement strategies with enhanced rates and additional funding based on quality and outcomes is certainly more innovative and progressive than traditional fee-for-service. It is time for the IDD system to move toward reimbursement policies that reward providers who are progressive in their service provision.

We are, however, concerned about the speed with which this incredibly complex systemic change is proposed to occur, and the amount of performance standards and measures proposed in this plan.

RCPA’s complete letter can be read here. For any questions, contact Carol Ferenz, Director, IDD Division.

0 629
Photo by Markus Winkler on Unsplash

The Office of Developmental Programs (ODP) has shared a reissue of ODPANN 24-039, which highlights the proposed performance-based contracting waiver amendments and rates. It was brought to ODP’s attention that there were several items that needed clarification within the original document. All changes are in red. Please only use this version going forward.

The reissue has updated the links for submitting comments. All other information remains consistent with the original ODP Announcement.

0 416

As a reminder, the public comment period ends next Tuesday, June 4, 2024, for the proposed implementation of Performance-Based Contracting for Residential Services, Waiver amendments, and proposed rates for services, which are effective July 1, 2024.

RCPA staff have participated in various listening sessions and met with members to hear your concerns regarding the proposed changes and rates. We will be sending our comments later this week and want to be sure that we are representing your interests. Please contact Carol Ferenz with any thoughts you have regarding these significant changes by close of business Wednesday, May 29, 2024.

Thank you for sharing your concerns. We strongly recommend that you take advantage of this opportunity to provide your own comments to ODP as well.

0 513
Photo by Markus Winkler on Unsplash

The Office of Long-Term Living (OLTL) announced that the department will be releasing the CHC and OBRA Waivers Amendments, as well as the proposed Rate Refresh Study details, in early June. In light of this information, the PD&A meeting currently scheduled for May 29 will be rescheduled. A new date and time will be sent to members as soon as the dates of these releases are available.

If you have any questions, please contact Fady Sahhar.

0 493

The Office of Developmental Programs (ODP) has shared ODPANN 24-031, which informs all interested stakeholders of the submission of the Consolidated, Community Living, Person/Family Directed Support (P/FDS), and Adult Autism Waiver (AAW) amendments that contain Workforce Recovery Supplemental Payments to CMS and provides guidance for requesting these payments. The submitted waiver amendments are available on the Department of Human Services website.

Please view the announcement for information and details, and note that providers are required to complete ODP’s survey to request these payments.

0 1218

The Office of Developmental Programs (ODP) has shared ODPANN 24-008. The purpose of this communication is to provide clarification regarding new residential qualification requirements in waiver amendments, effective November 1, 2023, including the release of a Frequently Asked Questions (FAQ) document. This clarification includes the requirement to have prior experience providing non-residential waiver services. Please view the announcement and FAQ document for information and details.

12Next Page 1 of 2
© 2021 - Rehabilitation & Community Providers Association