DHS
Tis the Season for a New Logo
June 3, 2024Following PHA’s recent announcement that it will be officially rebranded by Q3 with a new logo, database and website, the Department of Human Services issued a similar announcement that its…
Family Medical Support Assistance
June 3, 2024In 2022, ODP announced amendments to the Consolidated, Community Living and P/FDS waives that included NEW services funded through its waivers. One of those services is Family Medical Support Assistance,…
Effective May 1, CMS has approved amendments to ODP’s Consolidated, Person/Family Directed Support (P/FDS), Community Living, and Adult Autism Waivers allowing providers to request a one-time supplemental payment to cover recruitment, retention,…
Managed Care Program Annual Report (MCPAR)
May 13, 2024MCPAR information is now posted on the CHC website along with External Quality Review reports at CHC-Publications (pa.gov). MCPAR information is a summary of Medicaid managed care (MMC) and CHIP external…
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…
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…
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…
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…
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….
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…
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…
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…
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 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…
ODP Issues 2022-23 Annual Data Report
March 18, 2024The Office of Developmental Programs (ODP) has released its Annual Data Report, which includes statistical information on the individuals ODP serves and the services they receive. This data provides an overview…
The Pennsylvania Office of Medical Assistance Programs (OMAP) held a Pediatric Shift Care Stakeholder Update Call on February 29, 2024 to review the refreshed Improving Pennsylvania’s Pediatric Shift Care Nursing Through Collaboration. The…
Recommendations Released to Improve Coordination of Care, Services for Children and Young Adults with Complex Needs
February 26, 2024The Shapiro Administration has unveiled a report containing recommendations aimed at enhancing the coordination of care and services for children and young adults facing complex needs. This initiative, led by the Pennsylvania Department of Human Services (DHS),…
OLTL Presents at MAAC: 2024 Priorities and Annual Redeterminations
February 26, 2024On Thursday, February 22, the Office of Long-Term Living (OLTL) presented its 2024 priorities at the Medical Assistance Advisory Committee (MAAC) meeting. Deputy Secretary, Juliet Marsala, talked about strengthening the…
ODP Supports HCBS Providers: Proposes Recruitment/Retention One Time Payment, Rate Increases, and Waiver Capacity Expansion
February 26, 2024The Office of Developmental Programs (ODP) proposed a waiver amendment that includes a one-time supplemental payment to support providers with recruitment and retention. Following a recent comment period, ODP is…
ODPANN 21:046 Reissue & Correction
February 26, 2024The Office of Developmental Programs posted a correction for ODPANN 21:046, Process for 180-Day and 365-Day Timely Filing Edits: Exception and Special Handling Requests. Specifically, the mailbox for submitting claims for special…
Lunch and Learn Recap: RFA for Managed Care Organizations in Community HealthChoices
February 19, 2024On Friday, PHA hosted a Lunch and Learn to discuss the 500+ page document. Mia Haney, CEO, identified important CHC Agreement terms and potential changes that can affect PAS providers. Members…
Fraud Waste and Abuse Reporting
February 19, 2024A CHC-MCO must inform all network providers of the Pennsylvania Medical Assistance (MA) Provider Self-Review Protocol, which allows providers to voluntarily disclose overpayments or improper payments of MA funds. This…
ODP Announcement 24-021: ISAC Annual Report for 2023 Is Published
February 19, 2024Members of the Information Sharing and Advisory Committee (ISAC), working with the PA Office of Developmental Programs (ODP), developed a series of recommendations and strategies to support the achievement of…
Governor Supports Workforce; Calls for PAS Rate Study
February 5, 2024On Friday February 9, 2024, the Department of Human Services held a stakeholder presentation led by Secretary Valerie Arkoosh regarding the Governor’s recent budget which included an important call to…
The Office of Developmental Programs (ODP) has partnered with the National Association of State Directors of Developmental Disabilities Services (NASDDDS) and the Human Services Research Institute (HSRI) to administer the…
Requalification Reminders for ODP Waiver Providers
February 5, 2024As a reminder, all Office of Developmental Programs (ODP) waiver providers and vendors whose last digit of their Master Provider Index (MPI) number is 0, 1, or 2, as well…
Participant Directed Workgroup
February 5, 2024A workgroup of 40 people has been developed to determine why participant direction has seen a reduction of over 5,000 people since 2019. Their work should conclude in March with…
Community HealthChoices Request for Application (RFA) Released
February 5, 2024The Pennsylvania Department of Human Services (DHS) announced on January 30, that they are seeking to procure the services of managed care organizations (MCOs) to operate the Community HealthChoices (CHC)…
Kaiser Family Foundation Issue Brief
February 5, 2024Kaiser Family Foundation published an issue brief on Jan. 22 titled “Medicaid and State Financing: What to Watch in Upcoming State Budget Debates” that takes a national look at state…
The long-term services and supports (LTSS) subcommittee met on Thursday, Feb. 1. This was the first meeting since the Managed Long-Term Services and Supports Subcommittee (MLTSS) transitioned to the Long-Term…
In case you haven’t checked out the Office of Long-Term Living’s monthly data dash recently, the report now includes a breakdown of Community HealthChoices enrollment by county, as well as…
Shapiro Administration Launches PA Navigate
January 29, 2024Last week, the Pennsylvania Department of Human Services (DHS) announced the launch of PA Navigate, a new website that connects residents to agencies and community groups for access to health care…
Centene Names Richard Fisher as New CEO
January 29, 2024The current President & CEO of Wellcare, Richard Fisher, is taking on a new role in Centene’s operations team to bring more Medicare expertise to Centene. He’ll be working with…
After January 3, 2024, the Managed Long-Term Services and Supports Subcommittee (MLTSS) transitioned to the Long-Term Services and Supports Subcommittee (LTSS). Information for the LTSS subcommittee can be found on the LTSS Subcommittee…
AmeriHealth Caritas Names New CEO, Former Aetna Executive
January 22, 2024Kelly A. Munson has been selected to lead AmeriHealth Caritas as President and Chief Executive Officer starting February 1, 2024. Munson will succeed Paul A. Tufano, who stepped down in…
Reminder: Don’t Let Your Agency Credentials Expire!
January 15, 2024Don’t let license and credential expirations put a damper on your 2024 business plans! Take a moment this week to add a calendar reminder OR double check an existing calendar…
PAS Reductions Addressed During January MLTSS Meeting; Participate in Next Meeting on Feb. 1
January 15, 2024At the January 3 Managed Long-Term Services and Supports Subcommittee (MLTSS) Meeting, the CHC-MCOs presented on PAS service reductions. The presentation included data on PAS trends, face-to-face assessments vs. virtual assessments, PAS…
PA Medicaid Managed Care Quality Strategy (MCQS)
January 8, 2024The Centers for Medicare & Medicaid Services (CMS) requires states to have a quality strategy for their managed care programs. The PA draft MCQS was published for public comment on…
All claims and encounters for home health care services are subjected to EVV requirements for dates of service on or after January 1, 2024, and must have a corresponding EVV visit, or…
The Office of Long-Term Living (OLTL) Issues a Reminder on Critical Incident Management
December 18, 2023The Office of Long-Term Living Critical Incident Management Unit monitors provider compliance in the application of guidance specific to critical incident management. OLTL has identified compliance concerns and is issuing…
From June through August 2023, the Office of Long-Term Living (OLTL) held Listen and Learn Sessions across Pennsylvania. There were a total of 16 in-person sessions and three virtual sessions…
DHS Provider Quick Tip: Revalidation of Multiple Locations
October 9, 2023The Pennsylvania Department of Human Services Provider Enrollment Department has issued a new Provider Quick Tip on the Revalidation of Multiple Locations. To view the quick tip, click here.
Agency With Choice Update
September 18, 2023On September 11, 2023, the Commonwealth Court heard arguments in a preliminary hearing regarding PHA’s lawsuit against the Pennsylvania Department of Human Services (DHS). As members are aware, on December…
MA Program Fee Schedule Update for Act 62 Procedure Codes
September 18, 2023Effective September 5, 2023, the list of procedure codes subject to the MA cost avoidance process under Act 62 was updated to bring procedure code descriptions in alignment with national procedure code…
DHS Announces PPL as Statewide Fiscal Vendor, Updated Rates for FMS
September 11, 2023Last week, the Pennsylvania Department of Human Services (DHS) announced that announce that Public Partnerships, LLC (PPL) has been selected as the new statewide Vendor Fiscal/Employer Agent (VF/EA). PPL will…
DHS: Updates to Pediatric Shift Care Services for Beneficiaries Under 21 Years of Age
September 11, 2023DHS has announced it will cover personal care services provided to Medical Assistance (MA) beneficiaries under 21 years of age under the home health services benefit effective with dates of service on…
