HealthChoices—Pennsylvania’s managed care program for physical health, which includes our pediatrics practice—announced its newly rebid contracts in early 2017. For the past several years, this rebid process has been fraught with issues due to Managed Care Organizations’ (MCOs) protests. The newly announced contracts proved to be no different, as United submitted a contract bid protest shortly after this announcement.
United submitted this protest due to their belief that the state made an improper contract decision. Recently, Pennsylvania’s Commonwealth Court took up this protest and ruled in favor of United. The Court found that DHS met with MCOs during the black out period, thus ruling in favor of United’s protest.
DHS has not yet announced its next steps, but it is possible that the department will have to rebid all of HealthChoices’s contracts again. Because HealthChoices represents over $12 billion in contracts for potential MCOs, this ruling has created unprecedented waves in the state’s healthcare community. GAO will continue to monitor the outcomes of this ruling and will update the pediatric practice as more information becomes available.
Each year the PA Department of Aging and the Pennsylvania Homecare Association select one home health aide to be named Pennsylvania’s Direct Care Worker of the Year.
Last year BAYADA nominated 14 Home Health Aides (HHAs) and one of our nominees, Anne Pannone, was selected at PA’s Direct Care Worker of the Year. Since her selection, Anne was awarded a cash prize of $1,000 and has been invited to several statewide events to discuss the meaning of being a HHA and the value it provides to the state.
To help ease our service offices’ workloads, GAO is working with EMP to submit this year’s HHA nominations using information provided through our Hero program. To date, over 15 home health aides have been nominated to be this year’s Direct Care Worker of the Year.
All nominees will be invited to the 2018 Direct Care Worker Forum, which includes a luncheon and half-day training program on March 28. A stipend will be given to all HHAs attending the Forum.
Shortly after the new year the PA Department of Human Services (DHS) announced that the state will be moving forward with electronic visit verification (EVV) compliance by means of anopen system with a clearinghouse. BAYADA advocated on behalf of adoption of an open system and we are extremely pleased with DHS’s announcement. The open system encompasses the best of both worlds for providers within the state: An open system will enable providers that currently have an EVV system to use their system to “talk” to DHS’s clearinghouse. At the same time, it will also enable providers who do not currently use an EVV system to use the clearinghouse system as their provider.
Next, BAYADA plans to participate in a survey DHS will be releasing for the Department to better understand how home and community based providers are currently using EVV systems. DHS is also in the process of developing a request for information (RFI) to understand the features, challenges, and remedies in implementing the EVV clearinghouse. If applicable, BAYADA plans to participate in the RFI as well.