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Tags Posts tagged with "Waiver"

Waiver

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October starts the PA Family Network’s series on technology. Technology has become a major part of all our lives. For people with intellectual/developmental disabilities, technology can offer opportunities for independence, entertainment, choice, and control. Remote Supports are also now offered, providing more opportunities for services that can increase independence. Join the discussion as we talk about how technology and remote supports and can impact an Everyday Life! These workshops are created by family members and self-advocates FOR family members and self-advocates.

Register for upcoming events here.

October Workshops

LifeCourse Workshops

Waiver Workshops

Community Engagement Workshops (These are offered twice each day and won’t be repeated.)

Support Groups

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ODP Announcement 23-043 shares that the proposed amendments to the Consolidated, Person/Family Directed Support (P/FDS), Community Living, and Adult Autism Waivers and proposed rates for select services are available for public review and comment. There is a 30-day public comment period that starts on May 27, 2023, and ends on June 27, 2023, at 11:59 pm.

These proposed changes are scheduled to take effect November 1, 2023. ODP is also making available for public review and comment the rate setting methodology and fee schedule rates for select services in the waivers that are scheduled to take effect January 1, 2024.

The waiver amendments in their entirety can be found here.

Additional fee schedule rates are being added for:

  • Group music therapy, art therapy, and equine assisted therapy services provided through the Consolidated, Community Living, and P/FDS Waivers.
  • Needs Group 5 Residential Habilitation services provided through the Consolidated Waiver and Life Sharing Without Day Services provided through the Consolidated and Community Living Waivers.

The new Specialty Health Assessment and Coordination service in the Consolidated, Community Living, and P/FDS Waivers will be reimbursed monthly as a vendor service based on the cost that the provider charges to the general public. The rate changes proposed above are planned to become effective January 1, 2024.

In addition, ODP proposes to adopt the temporary enhanced rates for CPS and Transportation Trip as the fee schedule rates on November 1, 2023.

Information regarding the proposed waiver amendment changes and rates, including how to provide comments, can be found in the Pennsylvania Bulletin, Volume 53, Number 21, published on Saturday, May 27, 2023.

Comments and requests for copies of this notice and documents may be submitted to ODP via email. Comments submitted should use subject header ”Waiver and Rate Comments.” There are also webinars scheduled to provide public comment.

RCPA will be asking members for their input to our comments as well and will schedule a meeting to review this information shortly. If you have any questions or comments that you would like to be sure we include, please contact Carol Ferenz or Cathy Barrick.

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Medical insurance and Medicaid and stethoscope.

Join Pennsylvania Health Access Network (PHAN) on May 22, 2023, at 1:00 pm for a community conversation about Medicaid waivers. Amy Lowenstein, Director of Policy, and Pamela Putnam Silver, Supervising Attorney from the Pennsylvania Health Law Project, will discuss:

  • The end of COVID-era policies in the CHC and OBRA waivers and what they mean for those applying or receiving waiver services;
  • What to expect from the waiver renewal process;
  • Addressing changes in income and resources that may impact eligibility;
  • Where to go for help; and
  • Any questions and concerns.

Register for the meeting here.

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The Centers for Medicare and Medicaid Services (CMS) has approved the renewal of the Community HealthChoices (CHC) 1915(b) waiver effective January 1, 2023, for a 5-year period. Under the 1915(b) waiver, Pennsylvania operates the CHC managed care program.

As part of the CHC 1915(b) waiver renewal, the Office of Long-Term Living (OLTL) was required to obtain an independent evaluation or assessment of its CHC waiver program and submit the findings when renewing the CHC 1915(b) waiver.

The CHC 1915(b) waiver renewal and the Independent Assessment of the 1915(b) waiver are posted to the CHC-Supporting Documents website. Questions about the CHC 1915(b) waiver amendment or Independent Assessment can be submitted electronically.

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ODP Announcement 23-017 provides information regarding Remote Supports as a separate, discrete service in all four of the Office of Developmental Programs’ (ODP) waivers. Remote Supports is no longer covered as a component of the Assistive Technology service in the Consolidated, P/FDS, and Community Living waivers.

Guidance in the announcement includes how to add remote supports to the ISP, necessary provider qualifications, and enrollment process. Please refer to Attachment A for more instructions on how to add Remote Supports services for the P/FDS, Community Living, or Consolidated Waiver. Please refer to Attachment B for more instructions on how to add Remote Support Services for the AAW. Additional information about the qualification of a new specialty is contained in ODP Announcement 22-122 “Provider Qualification Process.”

Existing providers must submit the approved DP 1059 (ID/A) or DP 1088 (AAW) along with the “PROMISe™ Provider Service Location Change Request,” which can be found on the MyODP website, to the ODP provider enrollment inbox and/or AAW provider enrollment inbox in order to add a new Specialty 364 to an EXISTING active service location with the same Provider Type. Providers that do not have a Provider Type 51 service location open in PROMISe will need to submit an application through the Provider Enrollment system.

Questions regarding ISP requirements should be sent to the appropriate ODP Regional Office. Questions regarding provider qualification requirements should be sent to the ODP Provider Qualification inbox and the AAW Provider Enrollment Lead.

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The Centers for Medicare & Medicaid Services (CMS) has approved the Office of Long-Term Living’s (OLTL) Community HealthChoices (CHC) Waiver amendment that transfers oversight of Financial Management Services (FMS) from an OLTL-held contract to an administrative function of the CHC-MCOs and revises waiver performance measure AA-5. The amendment became effective on July 1, 2022.

The current approved CHC 1915(c) Waiver document with the FMS amendment can be viewed here. The link can be found under the heading “Community HealthChoices 1915(b) Managed Care and 1915(c) Home and Community-Based Waivers.”

Questions about the CHC Waiver amendment should be sent via email.

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