Home Care
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…
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…
PHA, in partnership with the PA Provider Advocacy Coalition, an organization that constitutes a variety of PA providers and advocates across all fields, recently sent a letter to the Shapiro Administration regarding…
November MLTSS Meeting Addresses PAS Reductions
December 11, 2023Last week, the Managed Long-Term Services and Supports (MLTSS) Subcommittee convened a meeting in Harrisburg. Of note, it was announced by Juliet Marsala, Deputy Secretary, Office of Long-Term Living, that…
Last week, KFF released findings from a recent analysis of state Medicaid Home and Community-Based Services (HCBS) programs’ waiting lists between 2016 and 2023. , KFF found that between 2016…
Improving Managed Care Appeals Process, Medicaid HCBS Discussed During November MACPAC Meeting
November 20, 2023This month, the Medicaid and CHIP Payment and Access Commission (MACPAC) held a public meeting that included presentations on improving the managed care appeals process, update on the continuous coverage unwinding, and…
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…
Payment Rates for Medicaid Home- and Community-Based Services: States’ Responses to Workforce Challenges
October 30, 2023A study by Kaiser Family Foundation (KFF), Payment Rates for Medicaid Home- and Community-Based Services: States’ Responses to Workforce Challenges, offers insights drawn from a Medicaid HCBS survey conducted across all 50…
ICYMI: HHAeXchange Issues Provider Notice on Visit Start Date
October 16, 2023HHAeXchange recently shared the following notification to providers: DHS has issued guidance pertaining to shifts where the actual start date is different than the scheduled start date. According to Systems…
CMS Proposes Changes to the HCBS 1915(c) Waiver Application
October 16, 2023In September 2023, the Centers for Medicare & Medicaid Services (CMS) posted proposed updates to the 1915(c) Home and Community Based Services (HCBS) Waiver Application and Technical Guide in the…
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.
AARP Releases 2023 LTSS Scorecard
October 9, 2023On Thursday, September 28, AARP released their 2023 Long-term Services and Supports (LTSS) Scorecard, the fifth iteration of the scorecard, which is released every three years. The Scorecard ranks all…
CMS released a Medicaid Transportation Coverage Guide, a compilation of Medicaid transportation policy providing a one-stop transportation resource for states on federal requirements and state flexibilities. The guide highlights existing policies…
Homecare Agencies Reestablished as an Approved Provider for CNA Renewals
September 18, 2023On Friday, PHA was contacted by the Dept. of Health to confirm that non-medical homecare agencies are approved providers for the purpose of CNA recertifications. In August, PHA was notified…
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…
DHS Receives Approval on Statewide Transition Plan
September 18, 2023On August 24, 2023, the Centers for Medicare and Medicaid Services (CMS) approved the Pennsylvania Statewide Transition Plan. The Statewide Transition Plan is considered the vehicle through which Pennsylvania documented…
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…
CMS Suspects Auto-Renewal Issue in Medicaid Disenrollments
September 11, 2023In a letter to all states, the Centers for Medicare & Medicaid Services (CMS) has reported issues with eligibility systems using auto-renewals that lead to wrongful disenrollments from Medicaid and CHIP, particularly…
Reserve your seat today and join PHA and OASIS Answers on August 28 – 29 in Harrisburg for a Blueprint for OASIS Accuracy Workshop. Following the workshop, attendees will have the opportunity…
