Authors Posts by Melissa Dehoff

Melissa Dehoff

Melissa Dehoff is responsible for all medical rehabilitation and brain injury service issues. Ms. Dehoff attends multiple state-level meetings to advocate on behalf of members on brain injury and rehabilitation issues and is a member of the Department of Health Traumatic Brain Injury Advisory Board.

The Pennsylvania Department of Human Services (DHS), Office of Long-Term Living (OLTL), will be conducting a webinar on the topic of the PA Achieving a Better Life Experience (ABLE) Savings Program on Tuesday, December 6, 2022 from 10:00 am – 11:00 am.

A PA ABLE account provides eligible individuals with qualifying disabilities, and their families and friends, a tax-free way to save for disability-related expenses while maintaining government benefits. Federal and state law authorized the creation of PA ABLE accounts. The presentation will be given by a representative from the PA Treasury Department.

OLTL Service Coordinators, Direct Service Providers, Community HealthChoices (CHC) managed care organizations (MCOs), staff, and any individuals that work on employment are strongly encouraged to participate in this webinar that will help you understand the PA ABLE Program and how it can benefit the OLTL participants you serve.

Please register here. After registering, you will receive a confirmation email containing information about joining the webinar. If you have questions regarding this email, please contact Ryan Dorsey at OLTL.

The agenda for the December 7, 2022 Managed Long-Term Services and Supports (MLTSS) Subcommittee meeting was just released by the Office of Long-Term Living (OLTL). The meeting will be held in person (Honors Suite, 1st Floor, 333 Market St, Harrisburg, PA 17126) and via webcast from 10:00 am – 1:00 pm. To receive the information to join the meeting, please register in advance.

The Centers for Medicare and Medicaid Services (CMS) published the calendar year (CY) 2023 Medicare Physician Fee Schedule (MPFS) in the Federal Register for November 18, 2022. Some of the key provisions contained in the final rule include (and are effective on January 1, 2023):

Medicare Telehealth Services

  • Addition of new HCPCS codes to the list of Medicare telehealth services on a Category 1 basis.
  • Implementation of the 151-day extensions of Medicare telehealth flexibilities, including allowing telehealth services to be provided in any geographic area and in any originating site setting.
  • Permission for physical therapists, occupational therapists, speech-language pathologists, and audiologists to provide telehealth services.
  • Listing of codes added to the telehealth services list are here.

Evaluation & Management (E&M) Visits

  • For CY 2023, CMS finalized changes for “Other E/M” visits that parallel the changes that were made in recent years for office/outpatient E/M visit coding and payment. Other E/M visits include hospital inpatient, hospital observation, emergency department, nursing facility, home services, residence services, and cognitive impairment assessment visits.

Behavioral Health

  • Proposal finalized to create a new HCPCS code (G0323) describing General Behavioral Health Integration performed by clinical psychologists or clinical social workers to account for monthly care integration where the mental health services provided are serving as the focal point of care integration.

Chronic Pain Management

  • Finalized a CY 2023 proposal to create two new G codes (G3002 and G3003) performed by physicians and other qualified health professionals describing monthly CPM for payment starting January 1, 2023.

Opioid Treatment Programs (OTPs)

  • CMS finalized the proposal to allow the OTP intake add-on code provided via 2-way, interactive, audio-video technology when billing for the initiation of treatment with buprenorphine using audio-video technology to start treatment with buprenorphine as authorized by the Drug Enforcement Administration (DEA) and Substance Abuse and Mental Health Services Administration (SAMHSA) at the time the service is provided.
  • CMS also finalized the proposal to permit the use of 2-way, interactive, audio-only technology to start treatment with buprenorphine in cases where audio-video technology isn’t available to the patient and all other applicable requirements are met.

The Department of Health and Human Services (HHS) released a new report that highlights patients’ experience of Long COVID to better understand its complexities and drive creative responses by government leaders, clinicians, patient advocates, and others. The Health+ Long COVID Report builds on President Biden’s Memorandum on Addressing the Long-Term Effects of COVID-19 and the two previously issued HHS Long COVID reports. The report was commissioned by HHS and produced by Coforma, an independent third-party design and research agency. It provides recommendations on how to deliver high-quality care and relevant and intentional resources and supports to individuals and families impacted by Long COVID.

Last week, the Administration sent a $750 million dollar supplemental funding request to Congress to support Long COVID research and treatment. This funding request would support HHS and their continued work on Long COVID, providers who serve patients with Long COVID and its associated conditions, and community-based organizations that assist with case management and provide other essential services and supports.

The report offers a variety of short-term and longer-term recommendations that come directly from the patient experience.

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The Centers for Medicare and Medicaid Services (CMS) announced that the next hospital/quality initiative open door forum has been scheduled for November 29, 2022, at 2:00 pm. Agenda topics for the call include:

  • Announcements & Updates
    • Hospital Price Transparency Sample Format Announcement
    • OPPS/ASC Final Rule Policies
    • Rural Emergency Hospital (REH) Policies
      • REH Conditions of Participation
      • REH Payment
      • REH Enrollment
      • REH Physician Self-Referral Law Update
    • OPPS Payment Policies
      • Annual Update
      • Remote Behavioral Health Services
      • 340B Drugs
      • Clinic Visit — Rural Sole Community Hospital Exemption
      • Payment Adjustment for Domestically Made N95 Masks
    • ASC Payment Policies
      • Annual Update
      • Non-Opioid Alternatives Under Section 6082 of the SUPPORT Act
    • Partial Hospitalization Program Policies
    • Organ Acquisition Payment Policies
      • Counting Research Organs
      • Costs of Potential Organ Donors for Cardiac Deaths
  • Open Q&A

To participate: dial 888-455-1397 and reference conference passcode: 5109694.

Instant replay (audio recording) of the call will be available: 888-562-0227 through December 1, 2022. No passcode is needed.

The Office of Long-Term Living’s (OLTL) American Rescue Plan Act (ARPA) Funding portal was launched September 30, 2022. Since the launch of the ARPA Funding Reporting portal, OLTL has received a higher than anticipated volume of portal access change requests, causing a delay in access to the portal. OLTL has also identified portal functionality and data discrepancy issues for which they are working with the Information Technology (IT) Development team to implement resolutions. As OLTL works to resolve the issues, the ARPA Funding Reporting Portal initial reporting due date of November 30, 2022, is being extended to February 28, 2023. Please reference the chart below for updated bi-annual reporting periods.

Report Period Due Dates
07/01/2021 – 12/31/2021

01/01/2022 – 06/30/2022

07/01/2022 – 12/31/2022

01/01/2023 – 6/30/2023 8/30/2023
07/01/2023 – 12/31/2023 2/28/2024

Portal Training & Support

Providers can use the DHS ARPA Reporting Portal User Guide to help navigate the new reporting portal. For portal access requests or questions, please contact the OLTL Provider Helpline at 800-932-0939, Option 2, or via email.

The Department of Human Services (DHS) released an announcement about an upcoming webinar that will focus on developing timely and acceptable Plans of Correction (POC). The webinar has been scheduled for December 12, 2022, from 1:00 pm – 3:00 pm.

The webinar, led by Jeanne Parisi, Director of the Bureau of Human Services Licensing (BHSL), and Joshua Hoover of the Division of Training and Professional Development, will review DHS’ timelines for licensing activities, BHSL licensing procedures, the necessary elements for developing a quality POC, the basics of root-cause analysis, and the resources and assistance that are available. Attendees will also have the opportunity to workshop POC with fellow providers and BHSL staff.

The webinar is approved for Personal Care Home (PCH) and Assisted Living Residence (ALR) annual training hours. Members interested in participating in this webinar should register here. Questions about the webinar or the registration process can be sent electronically.

The Centers for Medicare and Medicaid Services (CMS) has released a new Frequently Asked Question (FAQ) document that addresses how their review contractors (Medicare Administrative Contractors, Recovery Audit Contractors, and the Supplemental Medical Review Contractor) will conduct medical reviews after the COVID-19 public health emergency (PHE). Read the FAQ here.