Home Care
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…
Last week, the National Association for Home Care and Hospice (NAHC) filed a lawsuit against the Centers for Medicare and Medicaid Services (CMS) and the U.S. Department of Health and Human Services…
HHAeXchange Shares EVV Updates
June 5, 2023As follow up from questions received during the Annual Conference, HHAeXchange is sharing the following updates to PHA members. Home Health MCO Implementations HHAeXchange and the MCOs are continuing to…
On May 15, 2023, the Office of Medical Assistance Programs (OMAP) issued a Managed Care Operations Memo (MCOPS Memo) to the Physical HealthChoices Managed Care Organizations (PH-MCOs) to restate and update…
CMS Releases Findings from Technical Expert Panel, Listening Sessions on Hospice Special Focus Program Development
May 8, 2023As part of the Consolidated Appropriations Act of 2021 (CAA), Congress enacted significant changes to the hospice survey process, including a Special Focus Program (SFP) for poor performing hospice providers….
On April 27, 2023, the Centers for Medicare and Medicaid Services (CMS) released two proposed regulations that would significantly impact Medicaid programs, if finalized. Ensuring Access to Medicaid Services Proposed…
Recently, PHA has heard from members regarding discrepancies in EVV-related compliance reports available to providers and the MCOs. PHA reached out to HHAeXchange and the managed care organizations, and on…
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…
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…
On March 15, 2023, the Medicare Payment Advisory Commission (MedPAC) issued its March 2023 Report to the Congress: Medicare Payment Policy. As part of its annual report, MedPAC included the following home health and hospice recommendations:
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…