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Policy Areas

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The Centers for Medicare and Medicaid Services (CMS) recently notified the American Medical Rehabilitation Providers Association (AMRPA) that the rollout of the Review Choice Demonstration (RCD) would begin on August 21, 2023, in Alabama. In previous information released about the RCD, Pennsylvania is most likely to be one of the next states in line for this rollout. Under this demonstration, CMS Medicare Administrative Contractors (MACs) will review all Medicare Fee-for-Service (FFS) claims in select states. CMS will utilize a dedicated website to provide updated information and resources to inpatient rehabilitation facility (IRF) stakeholders.

RCPA is working closely with AMRPA staff and will keep members apprised of developments and updates throughout the demonstration. The RCD website confirms that affected IRFs will have the option to elect pre-claim or post-payment review (and must use the same option for all claims).

Photo by Markus Winkler from Pexels

The Office of Long-Term Living (OLTL) announced that Theresa Hartman is the new Director for the Bureau of Human Services Licensing (BHSL). See the announcement below:

Theresa is a dedicated health and human services professional that has dedicated her career to working with aging and disabled persons managing chronic and acute conditions for more than 30 years in Pennsylvania. Working as a nurse, she has done bedside nursing care, care management, and served in management and regional positions in the nursing home industry for over 20 years. In 2018, she made the move into Home and Community-Based Services as a Chief Operations and Compliance Officer for a Service Coordination provider and successfully led them through the transition from fee-for-service into the managed Community Health Choices program as well as NCQA accreditation. She also served on the PA HCBS Providers Board.

She is passionate about advocating for our most vulnerable populations, seniors, and those that are underserved. She believes we can improve the lives of our most vulnerable populations in Pennsylvania by supporting our providers and giving them the tools they need to succeed and reach the high-quality standards and requirements we set.

Theresa is joining the Department of Human Services from her role as Vice President of Clinical Services for GrayHawk Health, a healthcare practice provider that is building community-based programs to fill in care gaps for dual eligible populations across Pennsylvania. She earned her nursing degree from Drexel University and her Bachelor’s in Organizational Management from Eastern University. She is also a certified Case Manager and holds an active nursing license in Pennsylvania.

Questions may be sent electronically.

Medical insurance and Medicaid and stethoscope.

Join Pennsylvania Health Access Network (PHAN) on May 22, 2023, at 1:00 pm for a community conversation about Medicaid waivers. Amy Lowenstein, Director of Policy, and Pamela Putnam Silver, Supervising Attorney from the Pennsylvania Health Law Project, will discuss:

  • The end of COVID-era policies in the CHC and OBRA waivers and what they mean for those applying or receiving waiver services;
  • What to expect from the waiver renewal process;
  • Addressing changes in income and resources that may impact eligibility;
  • Where to go for help; and
  • Any questions and concerns.

Register for the meeting here.