';
CLOSE
Brain Injury

0 876
Deadline, as Letters on a Clock

The RCPA member Alternative Pay Arrangements/Agreements (APA) survey has been extended to close of business Wednesday, August 12. Members may access the survey here.

The survey responses we have received so far have provided excellent insight, and we look forward to collecting additional thoughts by extending the survey. We respectfully request that one survey be completed for each program areas if the APAs differ across your service continuum. The data we collect will be instrumental in our collective efforts with the Department of Human Services and managed care organizations regarding strategic fiscal considerations in the coming months.

Thank you for your support! If you have questions, please contact RCPA Children’s Division Director Jim Sharp or your RCPA Policy Director.

0 2391

Important Electronic Visit Verification (EVV) Reminders:

  • EVV Visit Data Requirements
    • The technical specification and addendum documents released by the Department of Human Services (DHS) are required to be followed as part of the EVV implementation. DHS must be able to aggregate all data by aligning data elements.
    • Required fields outlined in these documents are required to complete EVV implementation for all providers in all programs.
    • Entering false data in any of the required fields is not compliant for EVV implementation.  As an example, the last 5 digits of the direct care worker’s social security number is a required field and must be submitted to uniquely identify the individual providing the care.
  • EVV Error Status Codes (ESCs)
    • Providers currently submitting EVV data either through the DHS Sandata EVV system or their own Alternate EVV system need to verify that their PROMISe EVV ESCs are setting on claims the way they would expect.  If providers are getting errors they believe are inaccurate, providers should contact the Provider Assistance Center (PAC) by email or at 800-248-2152.
    • Please refer to the EVV ESC guidance document on the DHS EVV website for additional information.
  • Telephony Visit Verification (TVV)
    • Cell phones may only be used in conjunction with a location device.
    • Providers cannot require participants to have a land line or cell phone.  It is the provider’s responsibility to ensure caregivers have the necessary equipment for EVV.
    • If a provider solely uses TVV, the provider agency should consider either offering other visit capture modalities or using the DHS Sandata EVV system.
  • Office of Developmental Programs (ODP)/Office of Long-Term Living (OLTL) Medical Assistance (MA) Bulletin
    • Issuance is expected within the next 2 weeks.
  • Office of Medical Assistance Programs (OMAP) MA Bulletins
    • MA Bulletins have been prepared for OMAP providers and are currently undergoing executive review.
    • Issuance is anticipated to occur mid-August for Fee-For-Service (FFS) providers.

OMAP Updates:

  • OMAP FFS Providers
    • On August 3, 2020, a listserv communication was issued to home health care agencies regarding the DHS Sandata training webinar registration opening.
    • All OMAP FFS Providers planning to use the DHS Sandata EVV system must receive training for the DHS Sandata EVV System.
    • Training will be done using a “train the trainer” model either via live webinar of a self-guided online training course.
    • Providers may enroll for the training webinar beginning August 10, 2020 on the Sandata Learn Website.
    • The webinar will be conducted on August 28, 2020.
    • Providers may do self-paced training if they’re unable to attend the webinar.
    • Further information regarding training sessions will be sent to providers via a listserv email.

OLTL Updates:

  • All OLTL providers who render personal care services (PCS) are subject to EVV.  For claims that contain PCS with dates of service October 1, 2020 and forward, there MUST be a matching EVV record in the DHS aggregator in order for the claim to pay.  OLTL strongly encourages providers who are not already capturing EVV visits electronically, to do so NOW and ensure those visits are being sent and stored in the DHS Aggregator.  Providers already capturing PCS visits electronically should ensure they understand the meaning of any EVV edits that are setting and understand what corrections are needed to take place on the claim and/or EVV record for a claim to pay in the future.
  • Community HealthChoices (CHC) Providers
    • Providers serving Participants in CHC must implement an EVV system, follow all implementation directions provided by the CHC Managed Care Organizations (MCOs), and send EVV visit data to the CHC-MCOs. Providers have the option to utilize the HHAeXchange system offered by the CHC-MCOs or select their own Alternate EVV system.
    • As a reminder, providers using the HHAeXchange system offered by the CHC-MCOs do not need to complete Aggregator training or the Alt-EVV certification process.
  • FFS Providers
    • OLTL providers serving participants in the OBRA waiver or the Act 150 program must implement EVV for these programs by either:
      • Completing training and using the DHS EVV Sandata system.
      • Integrating an Alternate EVV system with the DHS EVV Aggregator to send EVV data for OBRA waiver and Act 150 participants.
      • Working with HHAeXchange (if applicable) to send the OBRA waiver and Act 150 EVV data separate from Community HealthChoices (CHC) data.
        • Providers choosing this option must confirm this process is completed with HHAeXchange.

ODP Updates:

  • All ODP providers who render personal care services (PCS) are subject to EVV.  For claims that contain PCS with dates of service October 1, 2020 and forward, there MUST be a matching EVV record in the DHS aggregator in order for the claim to pay.  ODP strongly encourages providers who are not already capturing EVV visits electronically, to do so NOW and ensure those visits are being sent and stored in the DHS aggregator.  Providers already capturing PCS visits electronically should ensure they understand the meaning of any EVV edits that are setting and understand what corrections are needed to take place on the claim and/or EVV record for a claim to pay in the future.
  • Agencies with Choice (AWCs)
    • AWCs are required to comply with all Departmental requirements as a condition of participation in the MA program.  Support Service Professionals (SSP) and/or Managing Employers are required to participate in the Department’s required EVV process.
    • In accordance with ODP Bulletin 00-08-08, Agency with Choice Financial Management Services (AWC FMS), “the AWC FMS provider is the employer of record responsible for certain employer functions,” which includes “assuring that Waiver and non-Waiver provider requirements are met.”  The individual or surrogate, as the managing employer of their qualified SSPs, is “responsible to verify time worked by qualified SSPs and approve and sign timesheets.”  This includes participation in the EVV process.  AWCs, therefore, have the authority to require SSP participation in the EVV process as a condition of employment.
    • Please contact your Administrative Entity with any questions you may have.
  • Vendor Fiscal (PALCO)
    • Effective August 16, 2020, PALCO is requiring All participant-directed services are captured electronically by the SSP.
    • EVV training materials and registration forms are available on the PALCO website.

DHS Sandata EVV Updates

  • Sandata Mobile Connect (SMC)
    • On August 17, 2020, DHS Sandata EVV will change the SMC app security lockout functionality to better align with PA DHS’ security requirements. Effective August 17, 2020, after 3 (three) “unsuccessful login” attempts in 15 minutes, a user will be locked out of SMC.
    • After this date, it is RECOMMENDED that upon two (2) unsuccessful attempts to log into SMC, users reset their passwords and not make a 3rd attempt to log in, risking getting locked out.  We ask all agency security administrators to please inform their respective staff members of this change.
  • Billing Module
    • The availability of the billing module has been delayed until 2021.  DHS will release more information as it is available.
    • Providers should continue to use existing billing processes.

A listserv has been established for ongoing updates on the CHC program. It is titled OLTL-COMMUNITY-HEALTHCHOICES, please visit the ListServ Archives page at http://listserv.dpw.state.pa.us to update or register your email address.

0 945

FOR IMMEDIATE RELEASE
August 7, 2020

Lancaster, PA – Department of Human Services (DHS) Secretary Teresa Miller and Department of Agriculture Secretary Russell Redding today visited Power Packs Project in Lancaster to assist with volunteer efforts keeping food available for families experiencing challenges from the COVID-19 pandemic and current economic insecurity. Power Packs Project partners with area schools in Lancaster and Lebanon counties to distribute nutritious weekend meals and recipes to families.

“Difficult circumstances created by the pandemic have not subsided, and many families around Pennsylvania still must endure challenges that come from COVID-19’s effect on food security,” said Secretary Miller. “Schools often provide at least one or two nutritious meals each day for students, but as summer continues and schools remain closed, students still need to eat breakfast and lunch. That’s where programs like Power Packs Project come in, bridging the gap when school breakfasts and lunches are not available. We know that going without meals can jeopardize children’s health and development, and the Wolf Administration is committed to doing everything it can to support families and connect them with the resources they need to get through this trying time. We are incredibly grateful to programs like Power Packs Project for their commitment to the communities they serve.”

“The Power Packs project not only provides food, but it also includes an educational recipe that can be used with the food found in the pack. This gives families the power to build nutritious, delicious meals, filling the void that exists when school is not in session,” said Secretary Redding. “We know COVID-19 has caused more people to use food banks and rely on programs like this. We estimate that in 2020, the Bureau of Food Assistance will move more than $80 million of USDA Foods through Pennsylvania’s charitable food system in all 67 counties, with the state’s allocation of The Emergency Food Assistance Program (TEFAP) funding from USDA. That is compared to 2019 when nearly $50 million was allocated to the purchase of USDA Foods. We are committed to assuring that even during difficult times, no one should go hungry.”

Power Packs empowers nearly 2,000 families with education and ingredients to create nutritious weekend meals, so their children return to school fed and ready to learn. During the school year, Power Packs children qualify for free- and reduced-price breakfast and lunch, ensuring that they will receive at least one or two nutritious meals each day. On weekends, when school lunches are not available, Power Packs fills the void by providing nutritious recipes, the ingredients for those recipes, and extras like peanut butter and cereal to see them through until Monday.

Power Packs Project has also provided summer distribution boxes in response to COVID-19 that contain shelf-stable milk and other products such as a protein, beans, cereal, peanut butter, and fresh produce when it is available. The boxes can be easily distributed to ensure that families still receive the nutrition they need.

“The COVID-19 pandemic has greatly impacted many families in our area. We have seen an increase in need, especially from individuals who have recently lost their jobs as a result of the pandemic and are facing food insecurity for the first time.  Power Packs Project will continue to work to ensure families receive the nutrition they need for their children to continue to grow and develop,” said Power Packs Project Executive Director Brad Peterson.

Pennsylvanians who need help feeding themselves or their family should find and contact their local food bank or pantry through Feeding Pennsylvania and Hunger-Free Pennsylvania.

Help with buying food is also available through the Supplemental Nutrition Assistance Program (SNAP). SNAP helps more than 1.9 million Pennsylvanians expand purchasing power by providing money each month to spend on groceries, helping households have resources to purchase enough food to avoid going hungry. Inadequate food and chronic nutrient deficiencies have profound effects on a person’s life and health, including increased risks for chronic diseases, higher chances of hospitalization, poorer overall health, and increased health care costs. As the nation faces the COVID-19 pandemic, access to essential needs like food is more important than ever to help keep vulnerable populations healthy and mitigate co-occurring health risks.

With the 2020-2021 school year right around the corner, the Wolf administration also reminds families to apply for free or reduced price meals through the National School Lunch Program (NSLP). Children from families with incomes at or below 130 percent of the poverty level, and children in families receiving SNAP or Temporary Assistance for Needy Families (TANF) are eligible for free lunches. Children in families whose income is between 130 percent and 185 percent of the poverty level are eligible for reduced price lunches.

Applications for SNAP, NSLP, TANF, and other public assistance programs can be submitted online at www.compass.state.pa.us. Those who prefer to submit paper documentation can print from the website or request an application by phone at 1-800-692-7462 and mail it to their local County Assistance Office (CAO) or place it in a CAO’s secure drop box, if available. While CAOs remain closed, work processing applications, determining eligibility, and issuing benefits continues.

Applications are processed within six days on average for SNAP and once a benefit is approved, it can be immediately accessed. All Pennsylvanians who are in a difficult financial situation due to the economic challenges of this pandemic should apply to see if they are eligible for assistance.

Secretary Miller and Secretary Redding also encouraged anyone who is healthy and able to consider taking some time to support their food bank, pantry, or charitable food organization through volunteer time or monetary donations, as this time is creating an incredible strain on organizations’ volunteer efforts and resources. Anyone interested in volunteering can find organizations in need of volunteer support on the United Way of Pennsylvania’s 211 website.

For more information about food assistance resources for people around Pennsylvania impacted by COVID-19 and the accompanying economic insecurity, visit https://www.agriculture.pa.gov/Food_Security/Pages/default.aspx.

More information on Power Packs Project can be found here.

NOTE: Photos are available from this visit. Please contact the DHS or Department of Agriculture press contacts if you would like these materials.

MEDIA CONTACT:    Erin James, DHS – ra-pwdhspressoffice@pa.gov

Emily Demsey, Agriculture – 717-603-2056

Brad Peterson, Power Packs Project – brad@powerpacksproject.org, 717-283-3131

# # #

0 1076

FOR IMMEDIATE RELEASE
August 7, 2020

Harrisburg, PA – Insurance Commissioner Jessica Altman today released the 2021 requested rate filings for health insurance plans under the Affordable Care Act, highlighting that the average rate requests would result in an average decrease in premiums in the individual market, allowing consumers greater flexibility and increased access to affordable, comprehensive coverage.

“Overall, Pennsylvania continues to have a healthy and competitive health insurance market and insurers are committed to providing the ACA coverage options Pennsylvanians deserve,” Altman said. “As filed, of Pennsylvania’s 67 counties, no county will lose an on-exchange insurer, and 13 counties will gain at least one new insurer. This marks the third year where Pennsylvania is seeing increased competition and decreasing or moderately increasing premiums, demonstrating that Pennsylvania’s efforts to stabilize and improve affordability in this market have been working.”

Insurers selling in the individual market filed plans requesting an average statewide decrease of 2.6 percent. Insurers that currently sell in Pennsylvania’s small group market filed plans requesting average statewide increases of 2.2 percent.

“Pennsylvania has taken the necessary steps to ensure ACA-compliant health care coverage is accessible, and continues to work towards making it more affordable,” said Altman. “Under Governor Wolf’s leadership, Pennsylvania is now switching to a state-based health insurance exchange later this year and establishing a reinsurance fund that will directly pay some of the health care costs for high-cost individuals.”

These key initiatives have driven down premium rates for 2021 and are the reason that premiums are, on average, going down in the individual market. Based on the proposed filings, the reinsurance program’s impact will make premiums 5.3% lower than they would be without this program in place, an even greater impact than the 4.6% decrease initially projected.

Other factors that are impacting these proposed rates include any anticipated costs related to COVID-19, such as COVID-19 testing and treatment costs, the anticipation of new treatments and vaccines, an increase in mental health and substance abuse treatment needs, telehealth utilization, as well as changes to provider reimbursement rates. The current economic turbulence and its accompanying impact on where people get their health insurance coverage, including a current and anticipated loss of employer coverage, is a factor as well.

The Department has observed thousands of individuals move to employer-sponsored COBRA plans during the COVID crisis. Many of these individuals may be eligible for Medicaid or may otherwise seek to enter the ACA individual market and access subsidies for the 2021 plan year, which will be a more affordable option than COBRA for many.

Rate filings for 2021 health insurance plans were submitted to the Insurance Department on May 19. The Department generally makes proposed rates public in July, but delayed the timeline this year to allow additional time to better understand the projected impact of COVID-19 on health care costs in 2021. Proposed rate changes vary by plan and region and are subject to change as the department conducts its review process. Final approved rates will be made public in the fall.

“Although the final rates are not yet approved and open enrollment is still a few months away, I urge consumers to begin thinking about their health care and insurance needs and encourage consumers to shop around when the state-based exchange platform is public,” said Altman.

Public comment on rate requests and filings will be accepted through August 21, 2020 and can be emailed to ra-in-comment@pa.gov.

Details are available on the Insurance Department’s website.

MEDIA CONTACT: Lindsay Bracale, lbracale@pa.gov

# # #

0 813

Today, the Pennsylvania Department of Drug and Alcohol Programs (DDAP) sent out resources for anyone seeking to learn more about social justice and racial inequality. The PA Care Partnership curated a collection of past webinar recordings to help deepen understanding of these vital issues. Please see the list of past webinars below:

Intersectionality Matters Cultural and Linguistic Competency Webinar

Sharon G. E. Washington is renowned for engaging diverse audiences on the complex intersections of race, historical trauma, social inequality and justice, and the impact of these factors on health outcomes. An award-winning educator, Sharon creates and instructs trainings reflecting the deliberate use of educational settings as safe spaces for healing from the social and cultural trauma of racism, sexism, homophobia, and other forms of oppression that limit the capacity of the human spirit, so that learners may use that power to heal the world.

Addressing Unconscious Bias to Create an Inclusive System of Care Webinar
Unconscious bias is defined as the automatic, implicit, and instantaneous association of stereotypes or attitudes towards an individual group of people. Participants learn how unconscious bias influences system of care success while providing pathways better to understand unconscious bias in mental and behavioral health care.

CLC Webinar Understanding Social Media Bullying, Bias, and Microaggressions PA Care Partnership
Technology has irrevocably changed the way we connect to others. Social media creates virtual spaces in which new forms of bullying arise, and in which technology-mediated communication and expression afford new ways to harm others. Participants will discuss the role and prevalence of social media bullying, bias, and microaggressions and their impact on systems of care. The webinar will explore the culture of social media and the tools for limiting bullying, bias, and microaggressions in our online worlds.

Culturally Responsive Systems of Care Often Engage The Family First
Learn about the distinct cultures of families, and the individualized supports to embracing their diversity. Building an authentic family partnership cannot be achieved when a system of care delivery is dominated by one cultural orientation. Participants will develop an approach for improving the integration of the family culture into their system of care work.

0 1256
Prev1...174175176...247Next Page 175 of 247
© 2021 - Rehabilitation & Community Providers Association