BAYADA Submits Comments on Electronic Visit Verification (EVV) to the Department of Human Services (DHS)

GAO recently worked with the Partnership for Medicaid Home-Based Care and internal stakeholders to submit comments to the Department of Human Services (DHS).

DHS released a Request for Information (RFI) to receive feedback on the technical specifications that should be considered when establishing an electronic visit verification (EVV) system.  DHS reinforced the message we had heard before stating that the state is moving towards an open implementation system with a standard clearing house.

BAYADA’s comments reinforced our position that an open system is imperative to foster innovation and enhance client care.  We look forward to continuing to work with the state to support the implementation of an open EVV system within the state.

If you have any questions about EVV or other mandates, please do not hesitate to reach out to me at lness@bayada.com.

DHS Secretary Testifies at Recent ACA Repeal Hearing

Submitted by Laura Ness, Director, Government Affairs (GAO)

Pennsylvania Department of Human Services Acting Secretary Teresa Miller was called to testify recently at the US Senate Committee on Finance during the Graham-Cassidy bill proposal.  This proposed legislation would have a traumatic impact to the home care industry.  Not only would it have limited health care coverage for millions of Americans it would have also block granted Medicaid which would limit Pennsylvanians access to home care services.

Because of our advocacy efforts and the advocacy efforts of others, the bill was removed from consideration.

There have been many action alerts this past quarter each one more important than the last. Thank you for taking the time to be a heart for home care and taking action!

Photo credit: PA Department of Human Services
DHS Acting Secretary Miller testifies in front of Senate Finance Committee Photo credit: PA Department of Human Services 

 

 

New Secretary of Pennsylvania’s Department of Human Services

Submitted by Laura Ness, Director, PA Government Affairs (GAO)

On August 17, Governor Tom Wolf announced that he asked the current Insurance Commissioner Teresa Miller to take over as the Secretary of the Department of Human Services (DHS).  Miller accepted and took over as Acting Secretary on August 21, replacing Secretary Ted Dallas.

Secretary Dallas has been out on medical leave since mid-June.  It is expected that Dallas will join Wolf’s executive office staff when he returns.  Secretary Miller was already tapped by Governor Wolf to lead the proposed unified department of health and human services that has yet to be approved by the legislature.  In the coming weeks, the Government Affairs Office (GAO) plans to meet with Secretary Miller to introduce her to BAYADA.

Why is HealthChoices Delayed?

Submitted by Laura Ness, Director, PA Government Affairs (GAO)

As many may know by now, the Department of Human Services recently announced they would delay and stagger the implementation of the new HealthChoices contracts. This was due to several bid protests and court battles currently working its way through the system.

This pushes the implementation to January of 2018.  The current plan is to rollout the new HealthChoices contracts:

January 2018                Southwest & Northwest

March 2018                   Northeast

July 2018                       Southeast

January 2019                Lehigh/Capitol

This will make the staggered roll-out similar to the Community HealthChoices implementation plan.

But why the delay?

Simply put, there are billions of dollars at stake.  The total funds available for HealthChoices are  estimated to be over $12 billion. So those organizations that do not win bids miss out on one of the largest state contracts in the US.

Number of Regions in Old ContractNumber of Regions in New Contract
Centene33
Health Partners12
United50
UPMC for You54
Keystone11
Gateway25
Aetna10
AmeriHealth32

This could also be one of the reasons why DHS is staggering the roll out. With the staggered roll out the Lehigh Capitol region transitions in January of 2019. This means that United and Amerihealth will get to keep their consumers for almost two years longer than originally anticipated.

We are still expecting court challenges which could delay the implementation further.

For your reference, I have included charts which details what MCOs were awarded what regions and the number of regions they were awarded.

GAO continues to monitor this situation and will update the pediatric leadership as more information becomes available.

 

 

 

 

 

Pennsylvania House And Senate Appropriations Committees Host Marathon Hearings

Submitted by Laura Ness, Director, PA Government Affairs (GAO)

Last week, the House and Senate Appropriations Committee hosted hearings for the Department of Human Services (DHS), the Department of Aging, the Department of Health, and the Department of Drug and Alcohol Programs. This was an opportunity for the various secretaries to defend the Governor’s proposed 2017-2018 budget.

Each hearing lasted for five hours and covered a variety of subjects.  Much of the discussion centered around the value of home care and Governor Tom Wolf’s proposal to increase the state’s minimum wage to $12 per hour. During the hearing, DHS Secretary Ted Dallas acknowledged if the minimum wage is increased, the state will also need to increase reimbursement rates. Secretary Dallas claims a $12 minimum wage would lift 145,000 Pennsylvanians out of poverty and off of assistance. The secretary has calculated that it would save the state $48 million in DHS spending.

PA Governor Tom Wolf Announces Plan to Consolidate Departments Crucial to Home Care

Submitted by Laura Ness, Director, PA Government Affairs (GAO)

During Governor Tom Wolf’s budget address, he proposed consolidating the Department of Human Services (formerly known as the Department of Public Welfare) the Department of Aging, the Department of Health, and the Department of Drug & Alcohol Programs.  If the consolidation goes through it will be called the PA Department of Health & Human Services.  It will also be one of the largest state agencies in the United States.  There are concerns by many advocacy groups that this could lead to additional bureaucracy and more items getting “lost in the shuffle”.  Wolf claims the consolidation will lead to seniors and disabled individuals having greater support and coordination of benefits.  BAYADA’s Government Affairs Office (GAO) will continue to track this proposal and evaluate the impact.  To read the full announcement click here.