Home Care
On May 22, the Medical Assistance Advisory Committee (MAAC) Consumer Subcommittee convened in Harrisburg for an in-person meeting, where key information was shared regarding hospital and contract updates, OLTL Participant…
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…
On April 30, the U.S. House Energy and Commerce Subcommittee on Health held a hearing titled “Legislative Proposals to Increase Medicaid Access and Improve Program Integrity” that included discussions regarding…
The Home and Community Based Services (HCBS) Quality Dataset was first implemented in 2022 with the intent establishing a national quality framework that allows for standardization of quality measurement and improvement activities…
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…
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…
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…
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….
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…
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….
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…
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…
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…
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…
OIG Releases New Medicaid Fraud Report
March 25, 2024The HHS Office of Inspector General (OIG) has released its FY 2023 Annual Report for Medicaid Fraud Control Units (MFCUs). The Report highlights the important role of MFCUs in investigating and prosecuting…
Aimed at bolstering support for caregivers of veterans, both the VA Caregiver Support Program (CSP) and Building Better Caregivers ®(BBC) have announced meaningful updates. These initiatives underscore the commitment to enhancing support networks and…
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…
2024 HCBS CAHPS Report: Participants Satisfied with Quality of Care, Workforce Issues Still Impacting Access
March 18, 2024Individuals receiving Medicaid home and community-based services are overwhelmingly satisfied with the care they receive, yet ongoing workforce issues continue to impact access to care, according to the2024 Home and Community-Based…
March is Fraud Prevention Month
March 18, 2024March is Fraud Prevention Month. Join PHA in recognizing the importance of combating fraud, waste, and abuse. We’ve compiled a list of tools and resources to assist you in staying…
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…
Change Healthcare Experiencing Cyberattack: HHAeXchange Puts Cautionary Hold on Claims
February 26, 2024UnitedHealth Group’s Change Healthcare, which is one of the largest health care technology companies in the United States, Feb. 21 was hit with a cyberattack that began disrupting a number…
U.S. Senators Express Concerns about Medicaid Access Rule
February 19, 2024Eleven Senate Republicans sent the Centers for Medicare & Medicaid (CMS) a letter expressing concerns about the Medicaid Access rule its consequences on February 15. The letter recommends that CMS: On…
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…
On January 26, 2024, the Centers for Medicare & Medicaid Services (CMS) forwarded the final Medicaid Access Rule (CMS-2442-F) to the Office of Management and Budget (OMB) for the last review…
HHAeXchange (HHAX) Includes Authorization Due Date
February 5, 2024HHAX Engineering is actively working to upgrade their environment for providers on the free portal to make it easier and faster to push enhancements to providers using the portal. HHAX…
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…
Avoid unnecessary takebacks by using www.phonevalidator.com. This free resource easily determines whether a number is a landline or cell phone. Take a few minutes today to check the numbers you have…
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…
Last week, PHA led a meeting with the majority and minority chairs of the House Human Services Committee and staff to educate them on Electronic Visit Verification (EVV) and the…
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…
Home care providers are NOT required to continue serving a participant who has lost Medicaid or Waiver eligibility and/or no longer has an active authorization for care. However, during the…