2024-04
MB Healthcare Consultants, LLC offers home care consulting services to PHA members at a 10% discount from standard fees. Services are based on three things: People, Process, and Performance. Visit www.mbhealthcareconsultants.com for…
April 25 Quick Hits: Here’s What You Missed
April 29, 2024On Thursday, April 25, Mia Haney, Alex McMahon, and Kim Whetsell recapped industry news and PHA updates in our members-only Quick Hits webinar. Information covered included PHA’s Advocacy Day, a…
Medicaid Access and Accountability 80/20 Rule Released
April 29, 2024The CMS final rule entitled, “Ensuring Access to Medicaid Services,” proposed to address key issues in Medicaid services, was issued this week. PHA issued a statement and is working diligently to review…
FTC Issues Rule Banning Noncompetes
April 29, 2024Last Tuesday, April 23, the Federal Trade Commission (FTC) issued a final rule banning noncompetes nationwide purporting that this effort protects the fundamental freedom of workers to change jobs, increases innovation, and…
ODP Releases Proposed Rate Schedule for HCBS with Increased Rates and Proposes Performance-Based Contracting for Res Hab, Supported Living, and Life Sharing
April 29, 2024ODP released announcements including their proposed fee schedules for community-based services, agency with choice and V/FEA models. The Office of Developmental Programs (ODP) additionally proposes to implement a 1915(b)(4) waiver…
PHA continues to hear from members in the Physical HealthChoices program regarding delayed payments due to the impacts of the Change Healthcare cyberattack. Specifically, PHA is aware of payment issues…
PAS Direct Care Worker Rate Study Update
April 29, 2024During the April 24 MAAC Consumer Subcommittee meeting the process for the PAS Direct Care Worker Rate Study was discussed. DHS indicated that they will start with the development assumptions…
ODP Releases Positive Approaches Journal
April 29, 2024The Office of Developmental Programs (ODP) and the Office of Mental Health and Substance Abuse Services have posted its Positive Approaches Journal. The first issue of the Positive Approaches Journal was…
CMS Issued Updates to Home Health Claims Processing
April 29, 2024The Centers for Medicare & Medicaid Services (CMS) has issued Change Request 14543, addressing critical aspects of home health care reporting, including county codes, notice of admission exceptions, telehealth service reporting,…
The latest MAAC Consumer Subcommittee Meeting provided an update on Shift Care Prior Authorization & Appeal Data. The presentation delved into HealthChoices through a series of insightful data sets. The…
Important Change: The May 1 go-live date for the Medicare hospice certifying physician enrollment requirement is delayed until June 3. The hospice physician enrollment requirement was originally set to begin on…
Care Compare Quarterly Refresh – April 2024
April 29, 2024The April 2024 quarterly refresh for the Home Health Quality Reporting Program is now available on Care Compare. For this refresh, Home Health (HH) Outcome and Assessment Information Set (OASIS) will…
Member Benefit Spotlight: DynaMed, Inc.
April 22, 2024The Pennsylvania Home Care Association is happy to provide a member benefit from our partners from DynamedDevices. DynaMed, Inc. is a national distributor for Stability Biologics. DynaMed offers access to…
REMINDER: The Medicare Credit Balance Report for the quarter ending March 31 is due by April 30, 2024. CGS Administrators, LLC (CGS) will suspend all claim payments at 100% if a completed…
On April 23, Pennsylvania will hold its Primary Election, where voters decide candidates for various positions. On the ballot are candidates for president, U.S. House and Senate, Pennsylvania’s three row…
PROPOSED NEW STANDARDS FOR PDN: Continuous Skilled Nursing Quality Improvement Act of 2024
April 22, 2024The Continuous Skilled Nursing Quality Improvement Act of 2024 (S 4122) was introduced this week in Congress. This bill intends to amend title XIX of the Social Security Act to develop…
NAHC Advocacy Day Recap
April 22, 2024Over 100 home care, home health, and hospice advocates, including representatives and members of PHA, came to Washington, D.C. April 16 and 17 to make the case for expanded access…
Amidst Caregiving Crisis, Casey, Kaine, Baldwin Introduce Bill to Revitalize Nation’s Long-Term Care Workforce
April 22, 2024Despite greater need for caregiving than ever before, care workers across the Nation are overworked and underpaid, resulting in a severe workforce shortage. U.S. Senators Bob Casey, Tim Kaine, and Tammy…
ODP Action Required: Update Your Provider Information
April 22, 2024ODP’s 24-035 announcement reminds providers must update their contact and service delivery information in the Home and Community Services Information System (HCSIS) and PROMISe before July 1, 2024, to ensure the transfer…
Earlier this year, a workgroup was established to explore the consumer self-direction program in Community HealthChoices with the intent of developing a set of recommendations for increasing enrollment in self-direction….
Last month Representatives Jessica Benham (D-Allegheny) and Jason Ortitay (R-Allegheny, Washington) issued a co-sponsorship memorandum titled “Agency Accountability and Livable Wages for PA’s Home Care Workers.” While the memo included…
NEW Study: Costs and Benefits of Enhancing Private Duty/Shift Nursing Payment Rates in Pennsylvania’s Medicaid Program
April 22, 2024The Pennsylvania Homecare Association engaged The Menges Group to conduct a cost savings study for private duty nursing with a purpose of proving what an investment in increased reimbursement rates…
There is a new location for accessing the Patient Assessment Change Request Forms effective immediately. The Change Request Forms for MDS, OASIS, IRF, LTCH, and Hospice can be found at…
Beginning May 1, 2024, physicians must be enrolled in or validly opted out of Medicare to certify a patient’s terminal illness under the Medicare hospice benefit. CMS has indicated hospices…
Hospice Item Set (HIS) Manual V3.02 Now Available
April 22, 2024An updated HIS Manual V3.02 is now available. The updates include an extension of the documents expiration date and several minor edits and date corrections. Updated documents include the HIS…
Today, PHA’s President of the Board of Directors, CJ Rambler, will be testifying on behalf of PHA at a House Health and Human Services Committee Informational Hearing on the Delivery…
Thank you to the 200+ attendees who came together last week to move the needle forward for Electronic Visit Verification (EVV) compliance in Pennsylvania! The Department of Human Services currently…
PHA reminds providers that eligibility checks for Medicaid participants should be run regularly as a best practice. This has become more important following the end of the Public Health Emergency,…
At the Long-Term Services & Supports (LTSS) Medical Assistance Advisory Committee meeting this week, the three CHC Managed Care Organizations presented information about their Participant Advisory Committee (PAC) Meetings. These…
Kaiser Permanente closes on Geisinger Acquisition
April 8, 2024Kaiser Foundation Health Plan and Hospitals, which make up the insurance and facilities half of Kaiser Permanente, announced the acquisition of Geisinger, a Pennsylvania-based health system and a Managed Care…
As reported in last week’s Connections, the fiscal year (FY) 2025 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, and Hospice Quality Reporting Program Requirements proposed rule has been…
HHAs: Preview Reports, Star Rating Preview Reports for July Refresh Now Available in iQIES
April 8, 2024Home health providers can now access their Preview Reports and Star Rating Preview Reports for the July 2024 refresh in iQIES. For this refresh Home Health (HH) Outcome and Assessment…
This blog introduces the Quality Pathway, a new initiative focusing on enhancing quality in healthcare. Authored by Dr. Susannah Bernheim, Chief Quality Officer at the CMS Innovation Center, and titled…
Annual Membership Meeting Scheduled for May 17
April 8, 2024PHA’s Annual Membership Meeting will be held on Friday, May 17, 2024, from 8:30 a.m. – 9:30 a.m. at Kalahari Resorts in the Pocono Mountains. All members are invited to…
The U.S. Department of Health and Human Services (HHS), under the Centers for Medicare & Medicaid Services (CMS), has finalized a rule aimed at enhancing access to care and safeguarding…
With the April 15 tax deadline approaching, the Internal Revenue Service (IRS) reminds taxpayers there is still time to file their federal income tax return electronically and request direct deposit….
The Next Generation Accountable Care Organization (NGACO) Model’s final report has been released, detailing lessons learned from its implementation between 2016 and 2021. This model aimed to improve value and…
PHA’s New Business Partner, ColdTree, proudly offers exclusive preferred pricing to all PHA members across an extensive range of products or “Swag” items. In addition to providing PHA members a discounted…
MAAC Reviews OLTL 2024–2025 Budget Proposal
April 1, 2024At the March Medical Assistance Advisory Committee, the Office of Long-Term Living (OLTL) presented their proposed Fiscal Year 2024–2025 budget, which included modest increases in utilization and cost of care…
On March 27, CMS issued a release regarding the Biden-Harris Administration’s final rule aimed at enhancing the enrollment process and maintaining health coverage for millions of Americans under Medicaid, the Children’s Health…
On September 1, 2023, the Office of Developmental Programs (ODP) announced that Public Partnerships, LLC (PPL) would be the new VF/EA, replacing the former VF/EA, PALCO. PPL began accepting new…
OLTL Comments on Rate Study
April 1, 2024At the March Medical Assistance Advisory Committee, the Office of Long-Term Living (OLTL) was asked to comment on the rate study proposed in the governor’s budget. The rate study will…
A new resource aims to boost the participation of people with disabilities in competitive integrated employment. Competitive integrated employment ensures that people with disabilities are paid competitive wages and work…
How to Apply for VA Benefits
April 1, 2024PHA frequently hears from members who are supporting veterans who aren’t aware of the benefits they may be eligible for. You can support your patients and their spouses to access…
On Thursday, March 28, the Department of Health & Human Services announced an extended enrollment period for Medicaid and CHIP renewals. This temporary Special Enrollment Period (SEP) will last through…
Recently, Representatives Jessica Benham (D-Allegheny) and Jason Ortitay (R-Allegheny, Washington) released a co-sponsorship memorandum titled “Agency Accountability and Livable Wages for PA’s Home Care Workers.” Unfortunately, this memorandum included unfounded…
CMS Proposes 2.6% Pay Raise for Hospices in 2025
April 1, 2024The Centers for Medicare & Medicaid Services (CMS) have proposed a 2.6% pay raise for hospices in the fiscal year 2025. This increase amounts to $705 million compared to FY…
In a post-acute care outreach email, CMS included that a new page has been added to help hospice providers with correcting demographic data. The page, “How to Update Hospice Demographic Data,”…
There will be a temporary pause in distributing CBRs and PEPPERs as CMS works to improve and update the program and reporting system, effective through the fall of 2024. For…
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