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CMS

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ODP Announcement 22-059 informs readers that the Office of Developmental Programs (ODP) is pleased to announce that an amendment to the AAW was submitted to CMS on May 9, 2022. The submitted AAW includes modifications that were made as a result of public comment. The AAW amendment includes the following substantive changes:

  • Adding reserved waiver capacity for individuals who are discharged from a state center. Reserved waiver capacity is also being added for participants who have been incarcerated for more than six consecutive months;
  • Aligning provider qualifications in the AAW with the Consolidated, Community Living, and Person/Family Directed Support (P/FDS) waivers, whenever possible;
  • Allowing relatives to deliver the Life Sharing component of the Residential Habilitation service;
  • Requiring that agencies that provide Residential Habilitation/Life Sharing must be qualified and enrolled to provide Residential Habilitation/Life Sharing in the Consolidated or Community Living waivers;
  • Increasing the annual fiscal limit in the transportation service to $5,000 per participant’s ISP year;
  • Allowing one of the four required monitoring conducted by the Supports Coordinator each year to be conducted remotely;
  • Adding a new service, Remote Supports; and
  • Delivering direct services using remote technology.

The requirements in the AAW will become effective when Appendix K flexibilities expire, six months after the expiration of the federal COVID-19 public health emergency.

Please note that aligning the Assistive Technology service, where possible, with the Consolidated, Community Living, and P/FDS waivers includes adding generators for the participant’s primary residence.

The full AAW application, as well as a record of substantive changes, is available here.

CMS has 90 days to review the amendment, and changes may occur to the content based upon discussion with CMS during the approval process. The proposed effective date of July 1, 2022, is also subject to change. ODP will inform all stakeholders when CMS has officially approved the AAW and will make the approved waiver available at that time.

Questions about this communication should be directed via email.

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ANCOR staff Lydia Dawson shared that in response to ANCOR’s advocacy, CMS has announced the release of its slide deck detailing how states can use corrective action plans to request additional time to comply with staff-dependent provisions of the HCBS Settings Rule due to the direct care workforce crisis.

As detailed in the slide deck, CMS will authorize corrective action plans to continue federal reimbursement of HCBS beyond the end of the transition period if states need additional time to ensure full provider compliance with staff-dependent provisions of the Settings Rule, including:

  • Access to the broader community;
  • Opportunities for employment;
  • Option for a private unit and/or choice of a roommate; and
  • Choice of non-disability specific settings.

This information was reviewed at the ACL/CMS webinar “Key Updates on the HCBS Settings Rule” held on May 25. When the recording is available, we will share it with our members.

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The Centers for Medicare and Medicaid Services (CMS) has been sharing information and bringing awareness about the Affordable Connectivity Program (ACP), a Federal Communications Commission (FCC) program. This new long-term program can assist individuals who use telehealth services to help lower the cost of broadband service for eligible households struggling to afford internet service.

The ACP provides:

  • Up to $30/month discount for broadband service;
  • Up to $75/month discount for households on qualifying tribal lands; and
  • A one-time discount of up to $100 for a laptop, desktop computer, or tablet purchased through a participating provider if the household contributes more than $10 but less than $50 toward the purchase price.

The ACP is limited to 1 monthly service discount and 1 device discount per household.

Who’s Eligible?

An individual’s household is eligible for the ACP if the household income is at or below 200 percent of the Federal Poverty Guidelines or if a member of the household meets at least 1 of the criteria outlined on the FCC’s website.

Individuals can enroll in two steps by:

  1. Going to ACPBenefit to apply online or print a mail-in application; and
  2. Contacting their preferred participating ACP provider to select a plan, who will apply the discount to the patient’s bill.

Some ACP providers may request individuals to complete an alternative application. Eligible households must apply for the program and contact a participating provider to select a service plan.

For Additional Information:

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The Centers for Medicare and Medicaid Services (CMS) identified an error in the patient counts for each inpatient rehabilitation facility patient assessment instrument (IRF-PAI) measure in the March 2022 provider preview reports (which were originally issued on April 13, 2022) related to the June 2022 refresh of IRF quality data on CMS Care Compare. CMS has updated the report to apply the COVID-19 reporting exceptions to only exclude stays that occurred in Quarter 1 (Q1) and Quarter 2 (Q2) of 2020. The March 2022 provider preview reports are currently available for review until May 27, 2022. Questions about the reports should be sent by email.

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The Centers for Medicare and Medicaid Services (CMS) has announced a virtual training program for both inpatient rehabilitation facilities (IRFs) and Long-Term Care Hospitals (LTCHs). The virtual IRF training program will review the updated guidance for the Inpatient Rehabilitation Facility – Patient Assessment Instrument (IRF-PAI) 4.0 and the LTCH Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) 5.0 for providers in the IRF and LTCH settings. This training is part of a comprehensive strategy to ensure IRF and LTCH providers have access to the education necessary to understand and comply with changes in reporting requirements associated with the IRF and LTCH Quality Reporting Programs (QRPs) that go into effect on October 1, 2022. A major focus of this training will be on the cross-setting implementation of the standardized patient assessment data elements being introduced in 2022 to ensure more consistent reporting and evaluation across post-acute care settings.

The training program consists of two parts:

  • Part 1: Beginning May 9, 2022: Access will be provided to recorded training session videos that deliver foundational knowledge necessary to understanding the new items and guidance. These videos are intended to be reviewed in advance of the live event.
  • Part 2: June 15–16, 2022: Live, virtual workshop sessions will provide coding practice on the items covered in the Part 1 videos. These live sessions will take place each day from 1:00 pm – 5:00 pm.

To participate in the training program, registration is required. If you have questions about accessing resources or feedback regarding the trainings, please email the PAC Training Mailbox. Content-related questions should be submitted to the LTCH QRP Help Desk and IRF QRP Help Desk

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The Centers for Medicare and Medicaid Services (CMS) recently announced the next Hospital/Quality Initiative open door forum has been scheduled for April 26, 2022, from 2:00 pm – 3:00 pm. Agenda topics that will be covered during this open door forum include:

  • Fiscal Year (FY) 2023 Inpatient/Long-Term Care Prospective Payment System (IPPS/LTC PPS) Proposed Rule
    • Hospital Quality Updates:
      • Background/Context on Health Equity and Maternal Health
      • Inpatient Quality Reporting (IQR) Program
        • Equity and Maternal Health Measures
        • Other IQR Measures and eCQM Reporting Requirements
        • Hospital Designation on Maternal Care
        • Requests for Information (RFIs) Re: Health Equity and Maternal Health
      • Measure Suppressions Due to the Impact of the COVID-19 Pandemic
      • Promoting Interoperability Program and Advancing Trusted Exchange Framework and Common Agreement (TEFCA) RFI
      • Hospitals and Critical Access Hospital (CAH) Conditions of Participation (CoPs) – Required COVID-19 Reporting Until December 2024, and Reporting in Future Public Health Emergencies (PHEs)
    • IPPS and Long-Term Care Hospital (LTCH) Update
    • RFI on Resource Costs for N95 Masks
  • IPPS Wage Index Timeline Update

There will also be an open question and answer (Q&A) session included during the hour. This call will be a conference call only.

To participate by phone:
Dial: 888-455-1397 & Reference Conference Passcode: 5109694
Instant Replay: 866-416-1185, Conference ID: No Passcode Needed

Instant Replay is an audio recording of this call that can be accessed by dialing 866-416-1185 beginning 1 hour after the call has ended. The recording expires after April 28, 2022.

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ODP Announcement 22-045 announces that the renewals of the Consolidated, Community Living, and P/FDS waivers were submitted to the Centers for Medicare & Medicaid Services (CMS) on April 1, 2022. CMS requires Medicaid waivers to be renewed every five years. The submitted waivers included revisions made as a result of over 500 public comments received from individuals and self-advocates, families, agencies, and organizations. Each full waiver application, as well as the Record of Change document that contains the substantive changes made as a result of public comment, is available online.

It is anticipated that the waiver renewals will be approved and effective July 1, 2022. The Office of Developmental Programs (ODP) will inform all stakeholders when the waiver renewals have been approved. The approved versions will be made available online at that time.

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