10/19/2020 UPDATE NOTE: THE INFORMATION CONTAINED IN THIS ARTICLE IS NO LONGER UP TO DATE. CHC-MCOs may now reduce PAS and other services. If your CHC-MCO has denied or reduced your PAS hours, call PHLP's Helpline for legal advice at 1-800-274-3258.
Community HealthChoices (CHC) Plans are not allowed to reduce existing home and community-based waiver services, including personal assistance services (PAS) and inhome nursing, during the COVID-19 emergency. This policy began March 18, 2020 and is in place until the emergency ends. This means that CHC Plans cannot issue any notices that reduce or take away waiver services, or otherwise cut waiver services, someone gets during this time.
Unfortunately, in April, almost 250 Pennsylvania Health & Wellness (PHW) CHC participants received notices cutting their PAS hours, despite the above policy. The notices were sent because of a misunderstanding about the scope of the moratorium. The problem is being fixed. However, PHLP is concerned that some CHC participants have gone for weeks with reduced PAS hours.
To remedy the error, the state has directed PHW to rescind the reductions, fully restore the original amount of PAS, and contact the affected participants and their home health providers to let them know the hours are restored.
What You Can Do:
- If you are aware of a PHW participant who received a notice dated March 18, 2020 or later stating their PAS hours would be cut AND that participant’s hours were already cut, reach out to the PHLP Helpline at 1-800-274-3258 or firstname.lastname@example.org. We will work with the participant to restore their hours quickly. If you are a home health agency, we urge you to provide PAS while you wait for the full authorization to be restored retroactively.
- If you are aware of an AmeriHealth, Keystone First or UPMC CHC participant who received a notice dated March 18, 2020 or later stating their PAS or other waiver services would be cut, please reach out to the PHLP Helpline at 1-800-274-3258 or email@example.com even if the participant is still getting all of their services. We will work with the participant to make sure the notice is rescinded and their services remain in place.
Note: When Pennsylvania ends its emergency declaration for COVID-19, CHC Plans will be allowed to issue waiver service reduction notices, and participants may receive new notices cutting their services, including their PAS hours. CHC participants who get a notice cutting their services should request a grievance within ten days of the date of the notice so they can continue getting those services while appealing. Participants are also encouraged to contact PHLP’s Helpline for advice or help.
Need more help?
As COVID-19 spreads, PHLP is committed to making sure those with Medical Assistance (MA) and Children’s Health Insurance Program (CHIP) coverage have services; to securing insurance coverage for the uninsured; and to keeping consumers informed. Visit our COVID-19 Resource Center today for the latest COVID-19 updates, state policy documents, and Frequently Asked Questions.