DHS
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…
New CPS Service Resource Now Available MyODP
July 31, 2023The recording of the Clarifications and Guidance for the Community Participation Support (CPS) Service in the Intellectual Disability/Autism (ID/A) Waivers webinar is now available on MyODP. Clarification and guidance on the CPS service and…
ODP Issues Home and Community-Based Settings Rule Assessments Licensing Results for FY 2021-22
July 24, 2023The Office of Developmental Programs (ODP) has released the second annual Home and Community-Based Settings Rule Assessments report, which contains licensing inspection data for inspections conducted during Fiscal Year (FY) 2021-22. Key…
The Department of Health and Human Services Office of Inspector General (OIG) recently announced a new Fiscal Year 2025 audit for hospices. The audit will “focus on claims for enrollees who were…
On June 28, 2023, the Office of Developmental Programs (ODP) released updated attachments to Bulletin 00-22-03: Technical Guidance for Claim and Service Documentation. The updated attachments reflect changes in the January…
On June 15, 2023, the Administration for Community Living (ACL) issued a proposed update to the regulations of the Older Americans Act of 1965 (OAA), which have not be substantially altered since…
ODP Restores Maximum Number of Hours Multiple Relatives, Legal Guardians Can Provide in ID/A Waivers
June 5, 2023On May 16, 2023, the Office of Developmental Programs (ODP) announced the restoration of maximum number of hours per week of In-Home and Community Support and/or Companion services that multiple…
PHA CEO Highlights Importance of Medicaid Program, Advocates for Additional Support at PA Capitol
May 1, 2023Last week, PHA’s CEO participated in a legislative information briefing at the Capitol. PHA joined fellow members of the PA Provider Advocacy Coalition to provide an overview of the Medicaid…
Office of Developmental Program (ODP) providers should be aware of an upcoming change to the EIM system related to the identification of targets. Effective May 1, 2023, when the selection…
On March 30, 2023, the Department of Human Services (DHS) submitted proposed regulations to implement the Adult Protective Services Act (APSA). The proposed regulation is intended to strengthen and clarify the…
Last week, the Office of Developmental Programs released the Quality Assessment & Improvement (QA&I) Individual Interviews Report for Interim Year 1 (FY 20-21) and Interim Year 2 (FY 21-22). The report provides…
On Friday, the Department of Human Services held an EVV Public Meeting that included program updates for both personal care services (PCS) and home healthcare services (HHCS). The full slide deck…
Last week, PHA received confirmation from the Department of Human Services (DHS) Office of Long-Term Living that the 2023 Community HealthChoices Amendment has been approved by the Centers for Medicare…
On March 6, the Department of Human Services (DHS) issued a Request for Information (RFI) seeking stakeholder feedback on the Community HealthChoices (CHC) program. DHS will use the feedback to evaluate opportunities…
OLTL Updates Critical Incident Management Bulletin
March 13, 2023Last week, the Office of Long-Term Living (OLTL) distributed its updated Critical Incident Management Bulletin, effective February 23, 2023. The bulletin is intended to clarify the definition of critical incidents and provide…
UPMC Updates Policy on Use of Consumer Cell Phones
March 13, 2023As reported in last week’s Connections, the Department of Human Services (DHS) addressed the use of consumer cell phones for EVV at the March MLTSS meeting, clarifying that DHS does not have…
ODP Issues Reports on Annual Data, Waiting Lists
March 13, 2023Last week, the Office of Developmental Programs (ODP) issued two reports:
At last week’s Managed Long-Term Services and Supports (MLTSS) Committee meeting, the Department of Human Services (DHS) clarified that the Department does not have a policy related to the use…
ODP Issues Guidance on New Report Supports Requirements
February 20, 2023Last week, the Office of Developmental Programs issued additional guidance on the requirements for the new Remote Supports service definition approved in the Consolidated, Person/Family Directed Support, and Community Living…
DHS Issues Bulletin on Shadow Nursing for Pediatric Patients
February 20, 2023On Friday, February 17, the PA Department of Human Services (DHS) issued Bulletin 05-23-02, 16-23-01, Coverage of Case Specific Training/Shadow Nursing for Private Duty/Shift Nursing Services for MA Beneficiaries Under 21…
ODP Publishes Everyday Lives: Values in Action 2022 Report
February 20, 2023The Office of Developmental Programs (ODP)’s Information Sharing and Advisory Committee (ISAC) has released its Everyday Lives: Values in Action Annual Report for 2022. This annual report includes statistical information…
DHS Says Parents Can Continue as Paid Home Health Aides for Medically Fragile Children
February 13, 2023Last week, PHA received notice that parents may continue serving as paid home health aides for medically fragile children, after the Department of Human Services (DHS), PHA, and other stakeholders…
Members Ask; PHA Answers: Nurse Shadowing for Pediatric Services
February 13, 2023In December, the Office of Medical Assistance Programs (OMAP) issued a Bulletin adding a rate for nurse shadowing for pediatric services. The nurse shadow rate is effective for claims with dates of…
2023 Community HealthChoices Agreement Now Available
February 6, 2023The 2023 Community HealthChoices Agreement between the Department of Human Services (DHS) and the CHC MCOs is now available. Changes and clarifications include the following:
OLTL Updates Monthly Data Dash
January 16, 2023The Office of Long-Term Living (OLTL) has posted its November 2022 Data Dash, providing a snapshot on statewide participation in OLTL waiver programs as of October 2022. The report includes…
As previously reported, last month the Independent Regulatory Review Commission (IRRC) voted to approve the final-form regulation allowing providers enrolled in the Medical Assistance (MA) program to co-locate. Last week,…
DHS Issues Bulletin Reinstating Provider Enrollment Requirements in February + Remember to Revalidate!
January 9, 2023On December 29, 2022, the Pennsylvania Department of Human Services (DHS) issued a Bulletin reinstating provider enrollment requirements that were temporarily suspended during the COVID-19 public health emergency (PHE).
DHS Adds New EVV Question to Provider Enrollment Application
January 9, 2023Beginning December 16, 2022, home health, homecare and other provider types will see a new question concerning Electronic Visit Verification (EVV) on the Additional Information page when completing a provider enrollment application:…