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CAADS WEBINAR MAY 26 | 2:30 PM - 4:00 PM (Pacific)
CBAS CERTIFICATION FOR NEW ADHC CENTERS
HELP II LOAN PROGRAM -- AFFORDABLE CAPITAL
What's New . . . May 25, 2016
Cal Duals Update
New Federal Regulation Will Help Ensure All Older Adults and People with Disabilities Can Access Health Care and Services Without Fear of Discrimination
MAY 23, 2016 | Source: Justice in Aging Health Network Alert
Last week, the Department of Health and Human Services (HHS) released the final rule implementing the non-discrimination provisions of the Affordable Care Act, otherwise known as Section 1557. This long-awaited regulation marks an important step in fighting discrimination in health care services for many different populations.
Both the statute and the rule interpreting it explicitly prohibit discrimination on the basis of race, color, national origin, sex, disability, and age. Section 1557 is the first federal civil rights law to prohibit discrimination on the basis of sex in health care, and the final rule interprets sex to include transgender individuals. Section 1557's protections apply to entities engaged in health services or health insurance coverage who receive funding from HHS. These include many who serve low-income seniors, like agencies within HHS - the Center for Medicaid and Medicare Services (CMS) - as well as Medicare and Medicaid providers and managed care plans.
Justice in Aging provided comments on the proposed regulation last year and will soon provide an analysis of the final rule from the perspectives of Medicare beneficiaries and those who serve older adults.
CBAS Updates - May 2016
Upcoming Training Opportunity
Webinar: “Adult Day Services in the Managed Care Environment: A Primer for Prospective Providers or New Managers” (May 26th, 2:30 p.m. to 4:00 p.m.)
On May 26th from 2:30 p.m. to 4:00 p.m., CDA will participate in the California Association of Adult Day Services’ (CAADS) webinar on “Adult Day Services in the Managed Care Environment: A Primer for Prospective Providers or New Managers.” The presenters will be Lydia Missaelides, Executive Director of CAADS and the Alliance for Leadership Education (ALE), Gretchen Brickson, Senior Director, Managed Long-Term Services & Supports, L.A. Care Health Plan and Denise Peach, Chief, CBAS Branch, California Department of Aging.
The webinar will orient prospective new providers and new staff members to the evolving managed care environment and the credentialing, contracting, electronic billing, service authorization, auditing, and other requirements associated with being a contracted managed care provider. It also will address the state’s expectations for communication with managed care plans during the pre-screening process and L.A. Care Health Plan’s internal process for analyzing the need for new CBAS centers.
Webinar registration information is available on the CAADS website.
Please Note: The New CBAS Provider Start-Up Training (sponsored by CAADS in partnership with the California Department of Aging and the Department of Health Care Services) that was tentatively scheduled for June 6th and 7th in Sacramento is on hold until further notice. Please contact the CBAS Branch if you have any questions cbas@firstname.lastname@example.org; (916) 415-7545.
Expanded FLSA Overtime Standards to be Effective DEC 1, 2016
MAY 20, 2016 | Source: National Adult Day Services Association (NADSA)
On May 18th the President and the Department of Labor announced changes to the Federal Fair Labor Standards Act (FLSA) regulations. Dubbed the “White Collar Overtime” rule, the new regulations will expand present overtime protections by increasing the salary levels under which they will apply. Initially, this expansion is expected to encompass approximately four-million employees nationally.
Generally, the Rule affects executive, administrative, professional, outside sales, and computer employees by raising the salary and compensation base under which these employees either must be paid overtime for more than 40 hours of work per week or must be given reduced hours.
The new base for most employees will be $913/wk (from $455/wk) and for Highly Compensated Employees it will be $134,004/yr (from $100,000/yr). The formal Rule is scheduled for publication in the Federal Register on May 23rd and will become effective on December 1, 2016.
Please visit the Department of Labor Blog for more information and to access additional links for specific information categories. If you are interested in how this rule effects non-profits, click here.
Medicaid and SSI in Need of Retooling
MAY 11, 2016 | Source: Justice in Aging Health Network Alert
Medicaid and SSI are two essential programs that fight senior poverty by ensuring that low-income older Americans can meet their basic needs and maintain their health. In operation for 50 years (Medicaid) and 40 years (SSI), these workhorse programs are indispensable for seniors. But as the population ages and income inequality increases, both programs need retooling to improve benefits and increase access for more people who need them.
Justice in Aging attorneys Georgia Burke, Jennifer Goldberg, and Kate Lang published “Medicaid and Supplemental Security Income Eligibility: Time for a Tune-Up,” in the spring issue of the National Academy of Elder Law Attorneys (NAELA) Journal.
This article recommends improvements for both programs to ensure that they continue to meet the needs of low-income older Americans now and into the future. You can learn more about the SSI Restoration Act here, and Justice in Aging's health care policy work here.
IMPORTANT CCI ANNOUNCEMENTS
MAY 6, 2016 | Source: Health Care Delivery Systems, Department of Health Care Services
In early April, DHCS shared for stakeholder comment a comprehensive strategy for the Coordinated Care Initiative (CCI) focused on improving the quality of care and care coordination in Cal MediConnect for beneficiaries, ensuring that beneficiary satisfaction remains high and increases, and generating sustainability for the program.
In total, DHCS received letters and comments that represented the views of more than 40 stakeholder groups. This robust stakeholder engagement is critical to the success of the CCI, and DHCS appreciates everyone who participated in the comment process.
Today, DHCS is sharing an update on its policy decisions, as well as additional materials for stakeholder comment. MORE
Social Security’s Rep Payee Program for Consumers
APR 28, 2016 | Source: Justice in Aging
The Social Security Administration’s Representative Payee program is an important program for ensuring that older adults who can no longer manage their finances have someone trustworthy and competent to do it for them.
As the population ages and the prevalence of cognitive challenges among the older adult population increases, the Rep Payee program will become even more critical and will play an important role in preventing elder financial abuse.
At Justice in Aging, we are working on creating a series of Fact Sheets about Social Security’s Representative Payee program and ways it can be improved. Our Fact Sheet for Consumers, What is a Social Security Representative Payee and how are they chosen? provides an overview of the basics of the program for consumers and other lay audiences.
If you’re a direct service provider for seniors, people with disabilities, and their family members, feel free to print up multiple copies of the Fact Sheet to distribute.
Third Wave of National Study of Long-Term Care Providers to Begin Summer 2016: All ADS Centers are Invited to Participate
APR 26, 2016 | Source: National Adult Day Services Association (NADSA)
Starting this summer, the U.S. Centers for Disease Control and Prevention’s (CDC) and National Center for Health Statistics (NCHS) will conduct the third wave of a biennial nationally representative survey of ADS centers, as part of its groundbreaking National Study of Long-Term Care Providers (NSLTCP). NSLTCP is an ongoing federally funded data collection effort to gather and report national and state information about the characteristics of ADS centers, other paid, regulated long-term care services providers, and the people they serve.
CDC uses the information collected through NSLTCP to produce publicly available reports and findings on the major long-term care services sectors including adult day services centers, assisted living and other residential care communities, home health agencies, nursing homes, and hospices. Reports from the second wave of the NSLTCP survey conducted in 2014 include Long-Term Care Providers and Services Users in the United States: Data from the National Study of Long-Term Care Providers, 2013-2014, reports with national results on ADS centers and participants, and tables with state information on ADS centers and participants. CDC thanks all of the ADS centers that completed and submitted your questionnaires in the second NSLTCP wave. Your participation made it possible to provide these accurate and relevant findings to you, other providers, policy makers, advocates, and researchers. MORE
Discovering What the ADS Financial Indicator Results Can Reveal About our Field
APR 26, 2016 | Source: National Adult Day Services Association (NADSA)
NADSA, CARF International, and Reinsel Kuntz Lesher LLP are conducting the 2016 ADS financial indicators study in fulfillment of the goal to develop financial benchmarks for the Adult Day Services field. This is the 7th year of this study and NADSA offers Annual Meeting presentation to reveal the study findings as well as a webinar for members. ADS centers that participated in the study also receive complementary individualized reports with their benchmarking data.
If your organization is an Adult Day Services provider, you are invited to participate in this complementary study. Instructions for participation are included in this article along with why this is valuable for your organization, and highlights from last year’s study. FULL ARTICLE
CMS Releases Final Medicaid Managed Care Regulation
APR 25, 2016 | Source: Justice in Aging
Today, the Centers for Medicare and Medicaid Services (CMS) issued a final regulation updating federal Medicaid managed care regulations. The final regulation is the first major update to Medicaid managed care in more than 10 years. Significantly, this regulation details, for the first time, federal expectations for states contracting with managed care plans that deliver long-term services and supports.
CMS issued the proposed rule last summer and received over 850 comments from the public. The regulations go into effect on July 6, 2016 and states and managed care plans will need to come into compliance with the rule by July 1, 2018.
Justice in Aging will analyze this sweeping regulation with an eye toward the impact on low-income older adults. The regulation has the potential to significantly change the way states, managed care organizations, aging network providers, advocates, and beneficiaries interact in the long-term services and supports delivery system.
Stay tuned for forthcoming Justice in Aging analysis and trainings on the regulation’s impact on older adults and long-term services and supports.
The regulation will be published in the Federal Register on May 6, 2016. The document is available here: https://s3.amazonaws.com/public-inspection.federalregister.gov/2016-09581.pdf.
DHCS Releases a New Provider Bulletin on Continuity of Care and Billing
APR 18, 2016 | Source: California Department of Health Care Services (DHCS), Health Care Delivery Systems
In order to ensure that beneficiary transitions into Cal MediConnect are smooth and do not result in disruptions of care, the CCI continuity of care policy gives beneficiaries in Cal MediConnect plans the right to continue seeing non-participating physicians for a limited period of time.
DHCS has developed a Provider Bulletin which explains how current out-of-network physicians can continue seeing Cal MediConnect beneficiaries, and the process for billing the correct entity for payment. It also provides information to help combat balance billing.
More information and additional resources for providers can be found on CalDuals.org.
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