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Authors Posts by Melissa Dehoff

Melissa Dehoff

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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.

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The PA BI Coalition has organized a 30 minute educational webinar for the entire State House and Senate with the help of the PA BI Caucus in Harrisburg. PLEASE take 5 minutes to call your legislator today and tell them to attend! Here are the high points they should expect:

  • Who is the Coalition and Caucus
  • Past accomplishments by these two groups
  • What is a brain injury
  • Unique crisis of brain injury and opioids & COVID
  • PA programs serving people with ABI (TBI, stroke, tumor)
  • Resources for your constituents

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On May 29, 2020, Governor Wolf signed Act 24 of 2020, which allocated funding from the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act to assist providers with COVID-19-related costs that were incurred between March 1, 2020 and November 30, 2020.  Providers that accepted Act 24 funding agreed to provide documentation to the Department of Human Services (DHS) and were required to submit an Act 24 cost report through a web-based portal between December 9, 2020 and April 30, 2021.

The Office of Long-Term Living (OLTL) is urging providers to take the following actions:

  • Review the List of Providers — OLTL has compiled a list of providers that received Act 24 funding but for whom there is no record of submission of a cost report or the return of funds. If your organization is on this list, OLTL is encouraging you to complete an Act 24 cost report and submit it to OLTL no later than Friday, June 11, 2021. There are a number of RCPA members on this list. The applicable cost reports can be accessed here. If you believe that your organization submitted an Act 24 cost report, forward a screenshot of your submission to OLTL.
  • Return Unused Funding — Providers that prefer not to complete and submit a cost report can return their Act 24 funding to OLTL by sending a check with a cover letter to OLTL indicating the check is for the return of CARES Act 24 funding they did not utilize. Checks should be made payable to the Pennsylvania Department of Human Services and sent to the Office of Long-Term Living, P.O Box 8025, Harrisburg, PA 17105-8025, Attn: Daniel Sharar.  Providers should include their EIN on the memo line of the check to ensure refunds are traceable to the correct provider.

DHS knows how important this funding has been to providers to cover COVID-19-related costs such as labor, Personal Protective Equipment (PPE), and testing supply costs and is encouraging providers to submit their cost reports by the June 11, 2021 deadline. DHS is obligated to report how these funds were used to the Pennsylvania legislature and return all unused funds to the U.S. Department of the Treasury. Providers that fail to submit a cost report or return their funding by the established deadline will be deemed by DHS to have no COVID-related expenses; DHS will proceed to recoup the Act 24 funding that was distributed to these providers. Questions and concerns can be directed to OLTL.

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On May 19, 2021, the Senate Finance Committee conducted a hearing, “COVID-19 Health Care Flexibilities: Perspectives, Experiences, and Lessons Learned,” that focused on how the flexibilities granted during the pandemic have been beneficial to patients and assisted providers in responding to the public health emergency (PHE). The hearing also discussed the potential for permanent policy changes after the pandemic and focused heavily on the support of telehealth.

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Photo by Markus Winkler on Unsplash

The Department of Human Services (DHS) issued an update regarding the implementation of an Enterprise Case Management (ECM) system to support the administration and management of various DHS-supervised programs.

A primary goal of ECM is to provide a complete picture of the DHS services provided to participants and families through multiple DHS program offices, regardless of the human services program or county providing the service. ECM will be implemented on a common technology platform that will be configured for various case management system needs across DHS programs. ECM will provide DHS staff and business partners with the tools needed to effectively serve participants by eliminating redundancies, lessening administrative burden, and streamlining core processes. ECM will mostly affect the Offices of Administration (OA), Children, Youth and Families (OCYF), Child Development and Early Learning (OCDEL), Mental Health and Substance Abuse Services (OMHSAS), Long-Term Living (OLTL), and Developmental Programs (ODP). When implemented, ECM will support a statewide child welfare case management system; enrollment and case management for Home and Community-Based Services (HCBS); intake and management for hearings and appeals; and application, enrollment, and support services for programs administered by OLTL. ECM will replace several legacy systems across program offices through the implementation of one common solution, composed of the following four major subsystems:

  • Home and Community-Based Services Subsystem (HCBSS): The HCBSS will replace what is currently known as the Home & Community Services Information System (HCSIS). It will serve as the enrollment and case management system for the DHS program offices, counties, and providers supporting the HCBS programs, including Medicaid waivers.
  • Hearings and Appeals: The Hearings & Appeals subsystem will replace the collection of legacy systems DHS uses to manage appeals under the jurisdiction of the Bureau of Hearings and Appeals (BHA).
  • Office of Long-Term Living Enrollment Services: The OLTL Enrollment Services subsystem will be used by an Enrollment Services Entity and DHS to manage the process to assist individuals/participants in exploring and applying for Long-Term Services and Supports (LTSS).
  • Child Welfare Case Management (CW CM): The CW CM subsystem will create a single, statewide Child Welfare Case Management System for all Pennsylvania Counties.

The ECM At a Glance document contains a high-level overview of DHS’ ECM initiative, positive impacts to participants, goals and objectives, scope and interfaces, and the anticipated timelines for subsystem implementations.

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The rate of emergency departments (ED) visits for bicycle-related traumatic brain injuries (TBI) and concussions decreased by almost half (49%) among children, but only by 6% among adults between 2009 and 2018 according to a new report in CDC’s Morbidity and Mortality Weekly Report.

Key findings from the report, “Emergency Department Visits Due to Bicycle-Related Traumatic Brain Injuries Among Children and Adults — United States, 2009-2018,” also show that:

  • There were more than half a million estimated ED visits for bicycle-related TBI in the U.S. during the study period.
  • The rate of ED visits for bicycle-related TBI decreased by almost half (49%) among children age 17 and under, and by only 6% among adults during the study period.
  • Among all age groups examined, ED visits for bicycle-related TBIs were highest for children ages 10-14 years.
  • The rate of bicycle-related TBI ED visits among males of all ages was three times greater than among females.

Bicycling is a great physical activity and is growing in popularity among Americans. Findings in this report highlight the need to expand effective bicycle safety interventions such as improving compliance to traffic laws, helmet use and bicycling infrastructure. These can help children and adults enjoy the benefits of bicycling and stay safe from injury, including TBIs.

Additional Information:

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The Centers for Medicare and Medicaid Services (CMS) published an interim final rule with comment period (IFC) in the May 13, 2021 Federal Register that revises the infection control requirements that long-term care (LTC) facilities and intermediate care facilities for individuals with intellectual disabilities must meet to participate in the Medicare and Medicaid programs. The goal of this IFC is to reduce the spread of COVID-19 by requiring education about COVID-19 vaccines for LTC facility residents, ICF-IID clients, and staff serving both populations, and by requiring that such vaccines, when available, be offered to all residents, clients, and staff. It also requires LTC facilities to report COVID-19 vaccination status of residents and staff to the Centers for Disease Control and Prevention (CDC). These requirements are necessary to help protect the health and safety of ICF-IID clients and LTC facility residents. In addition, the rule solicits public comments on the potential application of these or other requirements to other congregate living settings over which CMS has regulatory or other oversight authority. The regulations are effective on May 21, 2021; however, comments will be accepted but must be submitted by 5:00 pm on July 12, 2021 to be assured for consideration.

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The Senate Aging and Youth Committee has announced an upcoming public hearing on Thursday, May 20, 2021 at 11:00 am. This public hearing will focus on the current status and needs of long-term care facilities one year after COVID-19. This hearing will be live streamed and will also be archived for future viewing.

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The Centers for Medicare & Medicaid Services’ (CMS) accelerated payment program provides necessary funds when there are disruptions in claims submission and/or processing. The Coronavirus Aid, Relief, and Economic Security (CARES) Act (P.L. 116–136) expanded the program to include not only acute care hospitals, but also children’s hospitals, certain cancer hospitals, and critical access hospitals. CMS further expanded eligibility for accelerated/advance payments during the COVID-19 public health emergency (PHE) to all Medicare providers and suppliers.

On April 1, 2021, CMS issued a notice “Repayment of COVID-19 Accelerated and Advance Payments Began on March 30, 2021” for all Medicare providers and suppliers who requested and received COVID-19 Accelerated and Advance Payments (CAAPs) from CMS due to the COVID-19 PHE. It notifies providers that CMS began recovering the CAAP payments as early as March 30, 2021 (depending upon the one-year anniversary of when a provider received their first payment). The notice also provides information on how to identify recovered payments. Some highlights from the article include:

  • Accelerated payments function as a loan and must be repaid to CMS in full. The Continuing Appropriations Act, 2021 and Other Extensions Act, enacted on October 1, 2020, established new repayment terms for accelerated/advance payments. Among other provisions, the new terms include:
    • One year (from date payment was issued) before repayment begins — hospitals begin repayment as early as April 2021;
    • 25 percent withhold of Medicare claims during the first 11 months of repayment, followed by a 50 percent withhold during the subsequent six months; and
    • 4 percent interest applied to any remaining balance at the end of the repayment period.

The accelerated payments provided a critical lifeline to health systems during this PHE. The requirement to repay these funds could place health systems in financial distress while trying to recover from the pandemic. RCPA is requesting feedback from members on the impact of the accelerated payment relief plan. Please take a few minutes and respond to the following questions:

  1. Are you/your organization aware of the Accelerated Payment Relief program from CMS?
  2. Have you taken advantage of this?
  3. Are there any issues with the repayment?
  4. Have you been involved in any lobbying efforts to:
    1. Get this to better payment terms (e.g., interest rate, timing)?
    2. Move this to loan forgiveness?
  5. Have you contacted any state or federal legislators? If so, whom?
  6. Has your organization also received Provider Relief Funding and/or any other extraordinary CARES Act Funding?
  7. If so, has this impacted your interest in pursuing action relative to the Accelerated Payment Relief?
  8. Any additional comments?

Please send your responses to Melissa Dehoff by Wednesday, May 26, 2021.

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Photo by Christina @ wocintechchat.com on Unsplash

The Center for Connected Health Policy (CCHP) will be conducting their third webinar as part of their spring webinar series on May 14, 2021 from 2:00 pm–3:30 pm. This webinar, Medicaid Telehealth Policies for Seniors, will bring together Medicaid officials for a panel discussion about how state programs and Medicaid agencies incorporate telehealth into their services for seniors and other benefits for dually-enrolled for Medicare and Medicaid beneficiaries. State Medicaid presenters will also discuss relevant policy changes during COVID-19 and how that has impacted plans for the future of telehealth and seniors in their states. Members interested in participating in this webinar are encouraged to register as soon as possible.

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The Centers for Medicare and Medicaid Services (CMS) issued a reminder that the submission deadline for the inpatient rehabilitation facility (IRF) quality reporting program (QRP) is coming up on Monday, May 17, 2021.

IRF Patient Assessment Instrument (PAI) assessment data and data submitted to CMS via the Center for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) October 1–December 31 (Q4) of calendar year (CY) 2020 are due with this submission deadline. In addition, the annual NHSN Influenza Vaccination among Healthcare Personnel measure is also due with this deadline. The list of measures required for this deadline is found on the CMS QRP website.

As a reminder, it is recommended that providers run applicable CASPER/iQIES/NHSN analysis reports prior to each quarterly reporting deadline in order to ensure that all required data has been submitted.

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