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DPW Training on Preventing Financial Exploitation of Personal Care Home Residents

December 31st, 2009

The Pennsylvania Department of Public Welfare (DPW) Personal Care Home Licensing has announced a free training on How to Recognize, Reduce and Prevent Financial Exploitation of Personal Care Home Residents. The training will be held from 9:00 a.m. to 4:00 pm on the following days: January 25, 2010 (Monday) at Active Aging, Inc., 1034 Park Avenue, Meadville, PA 16335; on January 26, 2010 (Tuesday) at Four Points Sheraton Pittsburgh North, 910 Sheraton Drive, Mars, PA 16046; on January 27, 2010 (Wednesday) at Westmoreland Manor, 2480 South Grand Boulevard, Greensburg, PA  15601; on February 1, 2010 (Monday) at Pennsylvania College of Technology, Professional Development Center, 1 College Avenue, Williamsport, PA 17701; on February 2, 2010 (Tuesday) at Clark Summit State Hospital, Recreation Hall, (sign in at Communication Center), 1451 Hillside Drive, Clarks Summit, PA 18411; on February 3, 2010 (Wednesday) at Temple University Harrisburg, 234 Strawberry Square, Harrisburg, PA 17101; on February 5, 2010 (Friday) at Norristown State Hospital, Multi-purpose Room, Building #33, 1001 Sterigere Street, Norristown, PA  19401; on February 9, 2010 (Tuesday) at Pinn Memorial Baptist Church, 2251 North 54th Street, Philadelphia, PA 19131.  Registration is not required and will be held on-site on a first come first served basis. The limit is two (2) staff per home.  Training certificates will be provided.  Please be prompt – certificates will not be issued for late arrivals. Please use an online travel site for directions. FMI: Contact Daniel Price at 717-221-1689 for further information.

Joseph P. Kennedy, Jr. Foundation Seeks Applicants for 2010-2011 Fellowships

December 31st, 2009

The Joseph P. Kennedy, Jr. Foundation has announced that it is seeking exemplary professionals and/or family members of persons with intellectual or developmental disabilities who are currently working or volunteering in the field of inclusive services and supports for people with intellectual and developmental disabilities for an intensive one-year Public Policy Fellowship in Washington, D.C. The purpose of the fellowship is to prepare both early career and veteran leaders to assume leadership in the public policy arena in their home state and/or nationally. During this one year fellowship, the successful applicant will learn how federal legislation is initiated, developed, and passed by the Congress, as well as how programs are administered and regulations promulgated by federal agencies. The Foundation seeks applicants were involved in efforts to improve the lives of persons with intellectual and other developmental disabilities at the regional, state or national level. The expectation is that fellows will become future leaders in the field of inclusive community supports for people with intellectual and developmental disabilities.  The program provides a one-year full-time exposure to the federal public policy making process, and includes a stipend and modest relocation expenses. Selected fellows must be prepared to live in the Washington, D.C. area during their fellowship year and to devote themselves full-time to the fellowship. The application deadline for 2010-2011 is March 5, 2010 FMI: For more information on the Public Policy Fellowship contact The Joseph P. Kennedy, Jr. Foundation, 1133 19th Street NW, 12th Floor, Washington, DC 20036. See www.jpkf.org .

CMS Discontinues Use of Therapy Cap Exceptions Process on January 1

December 31st, 2009

On December 28 CMS said that continues to work with Congress on significant legislation which affects the Medicare program including the therapy cap exception process. Nonetheless, Congressional resolution will not be possible until a decision on the healthcare bill is made. In the meantime, if such legislation is enacted, CMS will notify Medicare fee-for-service claims processing contractors to again process claims for those affected services. Providers may choose to hold their claims in the event legislation about this issue is enacted. However, current law mandates that the exceptions to outpatient therapy caps expire on December 31, 2009. Outpatient therapy service providers should not submit claims with the KX modifier for services furnished on or after January 1, 2010.  The therapy caps are determined on a calendar year basis, so all patients will begin a new cap year on January 1, 2010 for physical therapy and speech language pathology services combined, the limit on incurred expenses is $1,860. For occupational therapy services the limit is $1,860. Deductible and coinsurance amounts applied to therapy services count toward the amount accrued before a cap is reached. Patients who have reached their limit(s) on outpatient therapy services, other than those who reside in a Medicare-certified part of a skilled nursing facility, may obtain medically necessary therapy services that exceed the caps if the services are furnished and billed by the outpatient department of a hospital. In other settings, outpatient therapy services in excess of the caps are not covered, and the therapy provider may charge the beneficiary for those services. FMI go to this link .

HHS OIG Issues Recovery Act Audit

December 31st, 2009

On December 22 the U.S. Department of Health and Human Services Office of Inspector General (HHS OIG) published its Recovery Act audit entitled Summary of Inspectors General Reports on Federal Agencies’ Data-Quality Review Processes (A-09-10-01002).  The Recovery Accountability and Transparency Board (Recovery Board) was established under the ARRA to provide transparency in the use of Recovery Act funds and to prevent and detect fraud, waste, and mismanagement. To help meet its mandate, the Recovery Board requested that the 29 Inspectors General (IG) of Federal agencies receiving Recovery Act funds determine whether the agencies had processes in place to perform limited data-quality reviews of recipient-reported information and to notify recipients of the need to make appropriate and timely changes. HHS OIG reports that as of November 3, 2009, 20 IGs had issued 21 reports. Because many of the IGs’ assessments were conducted before the recipients reported and corrected data, the objective of the IGs’ assessments did not include determining whether the agencies’ processes operated effectively. However, most of the 20 IGs indicated that they intend to evaluate the effectiveness of agency processes in future reviews. HHS OIG says that fifteen of the twenty IGs assessed agency processes for reviewing information reported by both grantees and contractors. The five other IGs advised the Recovery Board that they assessed agency processes only for grantees because the final OMB guidance for contractors was not available until September 30, 2009.  See the November HHS OIG Report . This report, accounting for Recovery Act funding, will be updated on a regular basis. FMI: See www.oig.hhs.gov .

COBRA Subsidy for Involuntarily Terminated Employees Extended

December 31st, 2009

On December 19 upon the signing into law by President Obama of the Department of Defense Appropriations Act, employees who are terminated involuntarily on or before February 28, 2010 and become eligible for COBRA are now entitled to a subsidy. The federal legislation also extends the eligibility period for the COBRA premium reduction through February 28, 2010, and expands from nine to 15 months the maximum period for receiving the subsidy. The American Recovery and Reinvestment Act of 2009 provides a government subsidy of sixty-five percent (65%) of the COBRA premium actually charged to anyone who became eligible for COBRA between September 1, 2008 and December 31, 2009 because of an involuntary termination of employment (other than for gross misconduct). Individuals who had reached the end of the reduced premium period before the legislation extended it to fifteen (15) months will have additional time to pay the reduced premiums. To continue coverage, thirty five percent (35%) of premium costs must be paid within sixty (60) days after date of enactment or, if later, thirty (30) days after notice of the extension is provided by their plan administrator. FMI: To obtain more details on the COBRA provisions, see this link . See also www.state.pa.us for December 23, 2009 press releases entitled Governor Rendell: Extension of Emergency Unemployment Compensation, COBRA Provides Immediate Financial Help to Pennsylvanians. For additional assistance, contact a federal Employee Benefits Security Administration Benefits Advisor, toll-free, at 1-866-444-3272.

CMS Places Hold on Claims under 2010 Medicare Physician Fee Schedule

December 31st, 2009

On December 23 the Centers for Medicare and Medicaid Services (CMS) published a special notice alerting the provider community that it is working with Congress, health care providers, and the beneficiary community to avoid disruption in the delivery of health care services and payment of claims for physicians, non-physician practitioners, and other providers of services paid under the Medicare physician fee schedule, beginning January 1, 2010.  CMS noted that President Obama has signed the Department of Defense Appropriations Act of 2010 which provides for a zero percent (0%) update to the 2010 Medicare Physician Fee Schedule for a two month period, January 1, 2010 through February 28, 2010. CMS says that it has instructed its contractors to hold claims for services paid under the Medicare Physician Fee Schedule (MPFS) for up to the first 10 business days of January (January 1 through January 15) for 2010 dates of service. This should have minimum impact on provider cash flow because, by law, clean electronic claims are not paid any sooner than 14 calendar days (29 days for paper claims) after the date of receipt.  Meanwhile, all claims for services delivered on or before December 31, 2009, will be processed and paid under normal procedures. CMS says that the holding of claims allows Medicare contractors time to receive the new, updated payment files and perform necessary testing before paying claims at the new rates. CMS has instructed contractors to begin processing claims at the new rates no later than January 19, 2010.  Please note that most contractors are closed on the January 18 Martin Luther King Day holiday.  Therefore, even absent a new update, most claims likely would not have been paid any sooner than January 19, 2010, given the aforementioned statutory 14-day payment floor. CMS has also extended the 2010 Annual Participation Enrollment Program end date from January 31, 2010, to March 17, 2010– therefore, the enrollment period now runs from November 13, 2009, through March 17, 2010. The effective date for any Participation status change during the extension, however, remains January 1, 2010, and will be in force for the entire year. Contractors will accept and process any Participation elections or withdrawals, made during the extended enrollment period that are received or post-marked on or before March 17, 2010. FMI: See this link .

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