Brain Injury

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The next Community HealthChoices (CHC) Third Thursday webinar has been scheduled for January 17, 2019, 1:30 pm – 3:00 pm. Some of the agenda topics to be included during this webinar include updates from Deputy Secretary Kevin Hancock on the initial CHC implementation efforts in the Southeast; and Randy Nolen will lead a discussion on launch indicators and Operations Reports data. In addition, the Office of Long-Term Living (OLTL) Chief Medical Officer, Dr. Lawrence Appel, will present on quality activities and performance measures in the Southwest from the first year of CHC.

To participate in the webinar, participants need to register. After participants register, a confirmation email will be sent containing information about joining the webinar.

Questions should be directed to the OLTL Bureau of Policy and Regulatory Management at 717-857-3280.

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The Office of Long-Term Living (OLTL) issued a billing clarification for Cognitive Rehabilitation Therapy (CRT) Procedure Code 97127 SE.

This procedure code can be billed by either billing each date of service separately per claim or by billing each date of service on separate detail lines of a date spanned claim.

Examples:

Billing each date of service separately per claim:

Would mean billing each date of service for each recipient for this procedure code individually. Each date is recognized as a new claim and will have a different ICN.

Billing each date of service on separate detail lines of a date spanned claim:

Would mean span dating the dates of service from one date to another date. At the bottom of the claims each date of service is a different line or number. This will show each day on a different line in the detail section of the claim.

Providers should continue to use the SE modifier per the OLTL fee schedule.

Questions regarding this clarification should be directed to the OLTL Provider Inquiry Unit via email or 800-932-0939.

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The Community Relations Manager for the Pennsylvania Independent Enrollment Broker (IEB) program (aka Maximus) has provided a map of Outreach Coordinators on the team and their coverage areas. This information was requested during the December 19, 2018 RCPA Physical Disabilities and Aging Division meeting.

Please Note: Jennifer Borgess in the North Central Region (shown in green on the map) is leaving the PA IEB (her last day will be January 4, 2019). Until a replacement is found for this region, if someone in that region reaches out to the PA IEB, please copy Joan Landis (Community Relations Manager) and Jahd Burns (her team supervisor) to ensure the issue is addressed by someone. Once a new coordinator in that area is hired and trained to take over this region, an updated map will be issued.

Contact Melissa Dehoff, RCPA Rehabilitation Services Director, with questions.

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The United States Senate Committee on Health, Education, Labor & Pensions (HELP) recently held an executive session and voted to advance S.3657 – the Traumatic Brain Injury Program Reauthorization Act of 2018. The bill included some increased funding (from $5,500,000 to $7,321,000 for 2020 through 2014) and reauthorized the Traumatic Brain Injury (TBI) State Partnership Grant Program, which is administered by the Administration for Community Living (ACL).

The bill also created and funded a national concussion data collection and analysis program through the Centers for Disease Control and Prevention (CDC) to determine the prevalence and incidence of concussion. Contact Melissa Dehoff, RCPA Director of Rehabilitation Services, with questions.

The RCPA staff and conference committee would like to thank you all for sponsoring, exhibiting, advertising, and/or attending the 2018 RCPA Annual Conference.

It’s official: The 2019 RCPA Annual Conference will be held September 24–27 at the Hershey Lodge, in Hershey, PA — be sure to mark this landmark event on your calendars!

It is our hope that, as you plan your 2019 events, you will once again consider supporting and attending the conference. Some other key dates to remember:

  • The 2019 Call for Workshop Proposals will be sent out by the end of January.
  • The request for sponsors, exhibitors, and advertisers will be sent out by the end of February.

For any questions about the RCPA Annual Conference, please contact Sarah Eyster, RCPA Conference Coordinator. We wish you all a happy and safe holiday season.

In order to promote improved coordination between Medicare and Medicaid as the rollout of Community HealthChoices (CHC) in the Southeast portion of the state gets closer, the Office of Long-Term Living (OLTL) released a CHC Medicaid/Medicare billing fact sheet. The fact sheet includes information and answers to frequently asked questions (FAQs) regarding coverage and how billing works under CHC.

Contact Melissa Dehoff with questions.