PACHC Outreach & Enrollment Director to be Honored
Tia Whitaker, PACHC's statewide director for outreach & enrollment, will be honored at the Pennsylvania Health Access Network (PHAN) annual conference on Oct. 14 with a 2018 Health Access Hero award. From Tia's notification letter, "Your unwavering commitment, heartfelt compassion, and proven leadership have helped thousands get covered and stay covered. You have fostered and supported a statewide network of people like yourself and ensured that they have the knowledge, skills, and support they need to get patients the care they need. You have been a steady guiding hand on this work, and, despite the challenges have maximized the impact in an uncertain environment with fewer resources than ever before. And you do all of this with a smile and sense of humor. Pennsylvania communities and people's lives are truly better because of your dedication to this work." Congratulations, Tia!
2019 Assister Readiness Webinar Series
The Centers for Medicare & Medicaid Services (CMS) will be presenting four webinars for enrollment assisters to give more in-depth information on the Health Insurance Marketplace open enrollment and other health insurance topics. Each week, training modules can be viewed at any time. The modules can be found on the Health Insurance Marketplace Training Resource webpage. The series of modules will have the following focus areas:
- Week 1 - Assister Roles and Responsibilities
- Week 2- 2019 Individual Marketplace Overview
- Week 3- Helping Consumers Apply for & Enroll in Coverage
- Week 4- Making Coverage Accessible
In addition to these on-demand training webinars, CMS will continue to host Friday live webinars with recaps of the week's topics of Oct. 12 to Nov. 2.
Medicare Open Enrollment begins October 15
For 2019 coverage, open enrollment for Medicarebegins Oct. 15, 2018, and ends Dec. 7, 2018. During the annual enrollment period, all people with Medicare can change their Medicare health plans and prescription drug coverage for the following year to better meet their needs. Consumers can get plan information or compare plans on Medicare.gov or by calling their local APPRISE office at 1-800-783-7067. If you are interested in becoming certified to assist patients and consumers with enrolling in Medicare and other Medicare programs, please contact Tia Whitaker, statewide director, outreach and enrollment.
Are You Getting the Latest CMS Updates?
The Centers for Medicare & Medicaid Services (CMS) sends a weekly assister newsletter to keep you informed and up to date on initiatives, important new releases, FAQs and the biweekly webinar schedule. To sign up for the CMS Weekly Assister Newsletter, please send a request to the Assister Listserv inbox, ASSISTERLISTSERV@cms.hhs.gov, write "Add to listserv" in the subject line, and please include the email address that you would like to add in the body of your email.
Community HealthChoices Is Coming to the Southeast
The mandatory managed care program for dual eligibles and other individuals with physical disabilities, Community HealthChoices (CHC), rolls out in the Southeast Zone Jan. 1, 2019. Individuals will be enrolled in CHC if they are 21 years old or over and are:
- Receiving both Medicare and Medicaid; or
- Receiving Long-Term Care and Support Services (LTSS) in the Attendant Care, Independence, COMMCARE, or Aging waivers; or
- Receiving services in the OBRA waiver AND determined nursing facility clinically-eligible; or
- Receiving care in a nursing home paid for by Medicaid; or
- An Act 150 participant who is dually eligible for Medicare and Medicaid.
There are three CHC Managed Care Organizations (MCO) providing services through the southeast CHC program: Keystone First/AmeriHealth Caritas; PA Health and Wellness; and UPMC. CHC-MCOs are required to provide coordination of long-term services and supports, Medicare services, physical health services, and behavioral health services. This would include working to transition participants from one setting to another more appropriate setting based on their assessed needs. CHC-MCOs are also required to ensure that the needs of participants with behavioral health issues are addressed, regardless of where they reside. For more information click here.