The Health Resources and Services Administration (HRSA) has published a Program Assistance Letter (PAL) recognizing the potential for telehealth to expand and improve access to health center patients. The PAL clarifies how health centers can utilize telehealth within their scope of project, how such services should be documented and when services may be considered an “Other Line of Business.” There are a number of issues that health centers need to consider when providing services via telehealth including provider licensure, informed consent, fraud and abuse laws, billing and payments and liability concerns. The Pennsylvania Department of Human Services payment policy currently limits FQHC/RHC telehealth to telepsychiatry.

Cultural competency and “Know Your Rights” training are some of the services available through Compass Immigration Legal Services (CILS), a 501c3 agency founded recently in southcentral Pennsylvania. CILS primarily provides family-based and humanitarian immigration services to those most in need. However, CILS also offers services to organizations such as healthcare facilities that serve immigrants of all cultures. Fees for all clients are based on an income-dependent sliding fee scale. For more information, see the company fact sheet or call John Leedock at 1-866-ASK-CILS.

Taxpayers must file a tax return if anyone on the tax return received Advance Premium Tax Credits (APTC) on a 2019 Marketplace plan. These individuals must also reconcile the amount of advance payments received against the eligible final credit amount. The taxpayer needs an IRS Form 1095-A and Form 8962 to reconcile. Form 1095-A is issued by the Health Insurance Marketplace and was to be mailed by Jan. 31. Form 8962 is used to determine the final premium tax credit and any overpayment or underpayment of APTCs. If these forms are not reconciled, the taxpayer may be subject to repayment of the full tax credit or discontinuation of current APTCs used to purchase their 2020 coverage on the Marketplace.

The Volunteer Income Tax Assistance (VITA) program offers free tax help to people who generally make $56,000 or less, persons with disabilities, and limited English-speaking taxpayers who need assistance in preparing their own tax returns. IRS-certified volunteers provide free basic income tax return preparation with electronic filing for qualified individuals.  Click here to find a location.

The Annual Medicare Advantage Open Enrollment period is Jan. 1 through March 31.  Consumers who are enrolled in a Medicare Advantage plan on Jan. 1 can switch to another Medicare Advantage plan (with or without drug coverage) or disenroll from their Medicare Advantage plan and return to original Medicare.  Anyone wanting to return to original Medicare will be able to join a stand-alone prescription drug plan for Part D coverage.  Only one change may be made during this period.  Any change made during this period will become effective the first day of the next month.  If consumers have specific questions, they can contact their local APPRISE location or call 1-800-783-7067 from 9:00 am to 4:00 pm Monday through Friday.

Last week, Reps. Ron Kind (D-WI) and Jackie Walorski (R- IN) introduced H.R. 5693, the Primary Health Services Enhancement Act. The bill would allow licensed physical therapists providing care at health centers to be reimbursed under both Medicare and Medicaid.

President Trump’s 2021 budget proposes massive reductions in Medicare and Medicaid spending, cuts that would be felt most acutely by hospitals and Medicaid beneficiaries. The budget would reduce Medicare and Medicaid spending by hundreds of billions of dollars each over the next decade. Although the Medicaid reforms are largely unspecified, if the administration’s past actions indicate future behavior, they’d likely include cuts to the Affordable Care Act’s expansion population and capping federal payments to states. For more, read Trump vs. Medicaid and the HHS FY2021 Budget in Brief.

Not one but two top Pennsylvania General Assembly legislative leaders will not be returning for the Legislature’s new session in 2021. On the heels of House Speaker Mike Turzai’s Jan. 23 retirement announcement, Senate President Pro Tem Joe Scarnati, R-Jefferson, announced this week he would not seek re-election in the 25th Senatorial District. Senator Scarnati’s announcement brings it to a total of 17 of the state legislature not seeking re-election. In addition, two other members are running for PA Auditor General and are giving up their House seats.

Gov. Tom Wolf announced this week that the Insurance Department, in partnership with multiple state agencies, released a survey asking healthcare providers for input on their experiences with barriers to mental health and substance use disorder treatment. The survey is part of the governor’s Reach Out PA: Your Mental Health Matters initiative, a long-term, statewide campaign that seeks to educate and empower Pennsylvania providers and consumers about consumer rights under state and federal parity laws. “The results from this survey will allow us to better inform and collaborate with providers, advocates and personnel on the front lines,” said Gov. Wolf. “Their experiences will help us enhance resources, develop more tools and create learning opportunities that will help serve the providers’ needs, which will ultimately help those in need of mental wellness services.” The provider survey will be sent directly to the email addresses provided to the Department of State through the licensing process. The deadline for responses is March 4, 2020.

Legislation allowing Medicaid managed care organizations (MCOs) to have access to the information in Pennsylvania’s Prescription Drug Monitoring Program (PDMP) was signed by Gov. Wolf this week after passage by both the House and Senate. Senate Bill 432 is premised on the hope that by providing MCOs access to the program, the commonwealth will be able to better identify potential prescription drug abuse among individuals enrolled in the state’s Medicaid program. The legislation also requires an MCO to notify the state Attorney General’s Office if they suspect a drug is being prescribed fraudulently and bars counties and municipalities from creating their own PDMPs. Pennsylvania’s PDMP, created in 2014, documents all filled prescriptions for controlled substances to ensure healthcare providers can safely prescribe drugs and stay on top of potentially misuse or addiction.