Policy Areas

ODP Announcement 090-15: New Schedule to Update Rates and ISP Data in HCSIS to Support the Provider Settlement Agreement

AUDIENCE:
Waiver Residential Habilitation Service Providers who signed the Provider Settlement Agreement Addendum, Administrative Entities (AE), Supports Coordination Organizations (SCO) and All Interested Parties.

PURPOSE:
This Office of Developmental Program (ODP) communication is intended to inform waiver residential habilitation service providers, who signed the Provider Settlement Agreement Addendum and participated in the rate retention factor (RRF) process, of the following: 

On Thursday, October 1, 2015, at 10:00 am, the House Energy and Commerce Health Subcommittee will hold a hearing, “Examining Potential Ways to Improve the Medicare Program,” that will include the review of three bills that strive to strengthen Medicare. The bills that will be examined include:

  • HR 1934, the Cancer Care Payment Reform Act, which would build on the promise of new provider delivery model development envisioned in the sustainable growth rate replacement policy, enacted into law earlier this year. This bill would establish a national oncology medical home demonstration project to improve Medicare payments for cancer care.
  • Draft legislation that would make changes to documentation and face-to-face requirements for home health providers under the Medicare program.

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One of RCPA’s members has asked for member feedback, via a survey on chronic pain patients that are being seen for Functional Capacity Evaluations (FCEs), to evaluate their eligibility to receive disability payments.

There are examples of where patients may not be physically able to return to their previous job, but would be able to perform other areas of work (more sedentary, less repetition, or other adaptations). However, many times these individuals continue to pursue disability because they do not know of, or have access to, other options.

We are curious if other members are providing FCEs for individuals applying for disability and if there are any return-to-work programs for individuals with chronic pain. Please complete this survey by Thursday, October 15, 2015, to have your responses included. Thank you for your participation.

The Office of Children, Youth and Families (OCYF) has compiled the responses from the survey conducted on the Child Protective Services Law (CPSL). Many of the questions that were posed in response to the survey are answered through the following handouts, as well as on the state’s CPSL website. Members are strongly encouraged to review the website and handouts.

The OCYF is coordinating with Bureau of Human Services Licensing to host a webinar for providers in November, in order to address questions on CPSL and provide further clarification. Additional details for this webinar will be available in the near future. After your organization has reviewed the materials provided, please send any additional, unanswered questions you may have to Nicole Good at OCYF by Friday, October 9, 2015. These questions can then be addressed during the webinar.

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The Centers for Medicare and Medicaid Services (CMS) recently issued a revised inpatient rehabilitation facility patient assessment instrument (IRF PAI) training manual. The updated sections of the training manual are located on the IRF PAI web page under Downloads.

The revised training manual only covers the changes made to the IRF PAI, including:

  • Revisions to the language in the Table of Contents, Section 7: Comorbid Conditions and Section 11: Clarification of Terminology;
  • Section 2: Item-by-Item Coding Instructions;
  • Section 3: The Functional Independence Measure (FIM) – Revised Language;
  • Section 4: Quality Indicators – Revised Language; and
  • Section 6: ICD-10-CM Codes Related to Specific Impairment Groups – Updated to Reflect ICD-10 Codes.

The updated training manual becomes effective on Thursday, October 1, 2015.