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Medical Rehab

Eleven years after the passage of the Affordable Care Act, the American Rescue Plan, passed last month in Congress, is the boldest expansion of health care in a decade. It will lower health care costs and expand access to healthcare coverage in a variety of ways.

We’re very excited to announce an opportunity to hear from Senator Bob Casey, PA Insurance Commissioner Jessica Altman, and Pennie Director Zach Sherman about how the American Rescue Plan will make healthcare more affordable for Pennsylvanians.

Join us for a Virtual Town Hall on Friday April 16th at 12pm to get your questions answered about the American Rescue Plan and its impact on healthcare. Register by clicking the button below and to receive the link to join the Town Hall.

Register Here

PA Health Access Network
1501 Cherry Street
Philadelphia, Pennsylvania 19102
877-570-3642

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The Centers for Medicare and Medicaid Services (CMS) has released the fiscal year (FY) 2022 inpatient rehabilitation facility prospective payment system (IRF PPS) proposed rule, along with a detailed fact sheet. The proposed rule is scheduled to be published in the Federal Register on April 12, 2021.

Some of the key provisions and proposed policy changes include:

  • Increase in net payments of 1.8 percent (or $160 million), relative to FY 2021 payments (CMS is also requesting feedback on whether FY 2019 claims data or FY 2020 claims data should be utilized to update payment rates due to the COVID-19 public health emergency).
  • Input requested on a number of potential new quality reporting program (QRP) measures.
  • Addition of a new IRF QRP measure: COVID-19 Vaccination Coverage Among Healthcare Personnel beginning in FY 2023 under the IRF QRP.
  • Revision to the data for public reporting/use on Care Compare to account for the 2020 QRP reporting waivers.
  • Outlier Threshold: CMS proposes to update the outlier threshold amount from $7,906 for FY 2021 to $9,192 for FY 2022.
  • Requesting information on revising the measure development and standardized patient ‎assessment data elements (SPADEs) collection to “address gaps in health equity in the IRF ‎QRP.”
  • Requesting information on future plans to define digital quality measures for the IRF QRP.

RCPA will review and discuss the proposed rule in the upcoming Outpatient Rehabilitation Committee and Medical Rehabilitation Committee meetings and utilize the feedback in developing comments on this proposed rule. Comments on this proposed rule are due by June 7, 2021.

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The Centers for Medicare and Medicaid Services (CMS) recently updated the list of telehealth codes to be covered under the Medicare Physician Fee Schedule (MPFS) for calendar year (CY) 2021 through the end of the public health emergency (PHE). Included in this updated list are services provided by speech-language pathologists and audiologists. The entire list of all currently permitted telehealth services under the CY 2021 MPFS are located here.

Photo by Markus Winkler on Unsplash

The Pennsylvania Department of Human Services is providing the below guidance as an update to the guidance issued on June 26, 2020, as updated on July 31, 2020, September 18, 2020, October 26, 2020, November 25, 2020 and January 28, 2021. As the Commonwealth – along with the nation – has obtained more data, deepened our scientific understanding of the COVID-19 virus, distributed vaccinations, and contemplated innovative policy options, our guidance continues to evolve.

Revisions are in red text. Facilities that are certified by the Centers for Medicare & Medicaid Services (CMS) should also continue to follow all relevant CMS guidance available now and in the future.

Visit the DHS website for the DHS’s long-term care guidance. Visit the governor’s website for the most recent mitigation order.

Central Penn Business Journal, April 2, 2021

By: Ioannis Pashakis
April 2, 2021 12:27 pm

Two Harrisburg health care associations were awarded a total of $250,000 in grant money as part of a national initiative to make access to telehealth services more equitable.

The Rehabilitation and Community Providers Association (RCPA) and the Pennsylvania Association of Community Health Centers (PACHC) announced this week that they will be using the funds to work with legislators and support strategies to ensure that as telehealth services expand as a way for patients to receive care from home that it is done equitably.

The initiative follows all-time highs in telehealth usage following the COVID-19 pandemic as providers shifted to virtual care during quarantine.

“Without being able to meet face to face in many cases, telehealth platforms quickly became the service delivery vehicle for providers, consumers, stakeholders, and payors,” said Dr. Richard Edley, president and CEO of RCPA. “As with every crisis, these challenges opened our eyes to new opportunities. But we still have a long way to ensure telehealth expands in an equitable way for providers and the communities we serve.”

RCPA and PACHC are two of six associations spanning eight states to be awarded the funding through the Delta Center for a Thriving Safety Net. The Delta Center, based in San Francisco, is a national collaborative created to foster innovation in value-based care and payment through policy initiatives.

RCPA is one of the country’s largest health and human services state associations with 350 member agencies and PACHCS represents and supports over 350 Federally Qualified Health Centers (FQHC).

As part of the grant, the two organizations will:

  • Drive policy and practice changes to ensure access to quality physical and behavioral services and improve integrated care through telehealth.
  • Partner with legislators and stakeholders to develop telehealth standards throughout the Commonwealth.
  • Support actionable strategies to address the social determinants of health
  • Share consumer feedback to develop training and technical assistance, health literacy campaigns and language supports.

“The integration of physical and behavioral health is critical to the future success of delivering high quality health care services to the patients of Federally Qualified Health Centers and behavioral health providers across the commonwealth,” said Cheri Rinehart, PACHC president and CEO. “The incorporation of telehealth services in the delivery of care was essential throughout the pandemic and will continue to be a crucial tool for providers to use in delivering whole person care for the communities they serve.”

Two Harrisburg associations focus on equitable telehealth care with new program. – Central Penn Business Journal (cpbj.com)