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Health Law News
February 24, 2022
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In This Issue

Client Spotlight: Keeping Maureen in Her Home

Maureen called PHLP's Helpline after she faced two service denials from her Community HealthChoices managed care plan (CHC-MCO): one threatening her personal assistance services (PAS), and one denying her access to a piece of medical equipment she needed to maintain her independence. 

Maureen is a 70-year-old woman who is non-ambulatory due to multiple chronic health conditions and history of cancer. In Fall 2020, Maureen called the Pennsylvania Health Law Project (PHLP) because, after over 5 years, her CHC managed care organization (MCO) decided to reduce her Personal Assistance Services (PAS) from 158 hours per week to just 63 hours per week. 
Read Maureen's story

CHC Participant Transition from PPL to Tempus Delayed Until July 1st


The Financial Management Services (FMS) transition from PPL to Tempus for Community HealthChoices (CHC) participants who use the self-directed model of care will now start July 1, 2022 instead of April 1, 2022. This delay was announced at the FMS Stakeholder Meeting held on February 18th. The decision to delay the start date for this transition was made to allow more time for CHC participants who serve as the Common Law Employers and their caregivers/Direct Care Workers to complete the necessary trainings and paperwork and ease concerns raised by numerous stakeholders about the pace of the transition...
Read the full article

2022 CHC Agreement Includes Important Changes for Participants


The Office of Long-Term Living (OLTL) amended the 2022 Community HealthChoices (CHC) Agreement, the contract that governs the CHC plans. While the amendments are awaiting final approval by Centers for Medicare & Medicaid Services (CMS), OLTL has indicated it will treat the CHC Plans as bound by the new changes effective January 1, 2022...
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ARP Funds Could Bring Much-Needed Relief to Direct Care Worker Shortage


At the end of 2021, the Centers for Medicare and Medicaid Services approved Pennsylvania’s plan for spending the enhanced funding available for home and community-based services under the American Rescue Plan Act of 2021 (ARP).  This paved the way for the Office of Long-Term Living (OLTL) to implement its plans for the increased funding, which includes three programs aimed at addressing the direct care workforce shortage in Pennsylvania:  increasing rates for personal assistance services (PAS), providing grants to home care agencies for worker recruitment and retention activities, and developing a participant-directed worker registry...    
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Pennie Offers Two New Special Enrollment Periods for Health Insurance
 

Pennie is a new health insurance marketplace, where uninsured Pennsylvanians can purchase health insurance, often with substantial financial help. The annual enrollment period for Pennie, or the time during which anyone can purchase insurance, occurs in the fall for coverage beginning January 1 of the following year.  For 2022, Pennie has announced two new Special Enrollment Periods: the first is for people with income is less than 150% of the Federal Poverty Level (FPL), and the second, called “Path to Pennie”, is for uninsured Pennsylvanians filing a state tax return...
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Reminder: Medicare Open Enrollment Periods


Now that we are in a new plan year for Medicare health and drug coverage, some Medicare beneficiaries may find that that their current coverage does not meet their needs.  Others who did not sign up for Medicare Part B when they were first eligible may be looking to enroll now. There are two enrollment periods available currently that have a March 31st deadline...
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Medicaid Now Covers COVID-19 At-Home Test Kits


As of mid-February, all Medicaid recipients in Pennsylvania should have access to free over-the-counter COVID-19 test kits.  Medicaid covers up to eight tests per month, and no doctor’s prescription is required...
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