At the suggestion of one of the assistant deans at the medical school, the incoming students at the University of Pittsburgh School of Medicine decided to update their oath for the first time in the 137-year history of the school. As they rewrote it, it became more explicitly inclusive of all people, including those historically overlooked by the medical community. It was embraced full-heartedly by the administration. The oath, which was taken by the entire 149-member class last month, acknowledges the lives lost to COVID-19, the killings of Breonna Taylor, George Floyd and Ahmaud Arbery, and the history of the “fundamental failings of our health care and political systems in serving vulnerable communities.” Read more.

As reported earlier, the Department of Human Services (DHS) has issued a Medical Assistance Bulletin establishing a separate vision PPS rate, effective Oct. 1, 2020, as well as adding vision to allow for up to four FQHC encounters per day (now medical, dental, behavioral and vision). Here are some points on the new vision PPS:

• Health centers already offering vision services are to individually work with DHS on calculation of a vision PPS rate from the prior cost report.
• PACHC has shared the updated cost report template as an attachment to the weekly All PA FQHC CEO Call summary, as well as with health center finance leaders.
• The medical and dental provider productivity benchmarks have not changed in the new cost report template and Opthalmology is 3,599 and Optometry is 2,530.

PACHC is awaiting DHS’ decision on how payments will be made from Oct.1, 2020 until the vision PPS rate is established for health centers currently offering vision. For example, retroactive reconciliation back to Oct.1, 2020 or just start the new rate when it is calculated.

Each year, FQHC/RHC prospective payment system (PPS) rates are updated on Oct. 1 by the Medicare Economic Index (MEI). The Department of Human Services (DHS) has notified PACHC that the state is having a system issue with letter download to email and therefore email notifications to health centers might be delayed. That does not mean that managed care organizations (MCOs) should delay implementation of the MEI adjustments. Per DHS:

• The MCOs and Promise received the data extract last week, which is available now to the MCOs and is set up to be easily imported into the MCOs’ systems.
• For these mass MEI rate increases, DHS expects MCOs to implement the MEI increase using the data extract provided and not wait for the rate confirmation letter DHS sends to each FQHC/RHC.
• It is important to note that this is different than the process for interim to final FQHC rate changes for individual health centers. While these are also communicated to MCOs through a (quarterly) data extract update from DHS, DHS directs MCOs to use the official rate letter DHS provides to the health center as validation of the rate change.

Questions? Contact Julie Korick, PACHC COO/CFO.

In June 2019, the Departments of Treasury, Labor and Health and Human Services jointly published a final rule to expand the flexibility and use of health reimbursement arrangements (HRAs). An HRA is a group health plan funded solely by employer contributions that reimburses an employee’s medical care expenses up to a maximum dollar amount for a coverage period. HRA reimbursements are excludable from the employee’s income and wages for federal income tax and employment tax purposes. In addition to the employee, an HRA may also reimburse expenses incurred by the employee’s spouse, dependents, and children who as of the end of the taxable year, have not attained age 27.

The Senate voted to limit debate on short-term agency spending, and passed the Continuing Resolution (CR) previously passed by the House of Representatives last Tuesday, Sept. 22. The CR provides a stopgap for government funding to avoid a shutdown and extend government-funded programs until Dec. 11, 2020. The bill also includes an extension of mandatory funding for the Health Center Fund, the National Health Service Corps, and the Teaching Health Centers Graduate Medical Education Program until Dec. 11.

The Wolf Administration in collaboration with the General Assembly and other agencies released Pennsylvania’s Statewide Suicide Prevention Plan which can be found here. According to the Centers for Disease Control and Prevention (CDC), suicide is the tenth leading cause of death in the country, claiming more than twice as many lives each year as homicide. Approximately 1.4 million adults attempt suicide annually in the U.S., with more than 85 percent reporting having made a suicide plan prior to their attempt. In Pennsylvania alone there were tragically 2,017 people who completed suicide in 2018. The plan, developed by the state’s Suicide Prevention Task Force, is a four-year strategy to reduce suicide in Pennsylvania by fighting stigma, increasing training and education on suicide and mental health, improving data collection for suicide, and supporting clinical practices and treatment to prevent suicide and help those who are struggling or in crisis. Moving forward, the task force will continue working with stakeholders at the local, regional, and state levels to support and monitor the implementation of the plan. Click
here to learn more.