DHS COVID-19 PROVIDER GUIDANCE // OLTL
Coronavirus Aid, Relief, and Economic Security Act (CARES Act) Funding for Office of Long-Term Living
(OLTL) Community HealthChoices (CHC) Managed Care Organizations (MCO) and Living Independence
for the Elderly (LIFE) Organizations
Issued: June 22, 2020
Governor Wolf signed Act 24 of 2020, which allocates funding from the federal Coronavirus Aid, Relief,
and Economic Security Act – also known as the CARES Act. Act 24 established funding from the CARES
Act to be used to cover necessary COVID-19 related costs for identified persons and entities incurred
between March 1, 2020 and November 30, 2020. Act 24 includes $457,000,000 of COVID-19 relief funds
for providers of Long-Term Living Programs. To qualify for the one-time payment, the person or entity
must be in operation as of March 31, 2020. This funding will be used to provide the following payments
to CHC-MCOs and LIFE Organizations:
- COVID-19 CHC-MCO Payment
The total funds available for a one-time payment to CHC-MCOs pursuant to Act 24 (CHC-MCO
COVID-19 Payment) is $50,000,000.
The CHC-MCO COVID-19 Payment for each CHC-MCO is calculated by dividing the CHC-MCO’s
number of Nursing Facility Clinically Eligible (NFCE) participants as of March 31, 2020 by the sum
of all CHC-MCO’s NFCE participants as of March 31, 2020 to obtain a specific quotient for each
CHC-MCO. Each CHC-MCO’s quotient is then multiplied by $50,000,000 to determine its CHCMCO COVID-19 Payment.
- COVID-19 Managed Long-Term Care Organization Payment
The total funds available for a one-time payment to Managed Long Term Care Organizations,
which are known as LIFE Organizations, pursuant to Act 24 (LIFE COVID-19 Payment) is
$10,000,000. An organization qualifies for the LIFE COVID-19 Payment if the organization has:
(a) entered into an agreement with the Department to operate a LIFE program as defined under
section 602 of the Human Services Code, and (b) operates a LIFE program in a specified county
or set of counties, as determined by the Department.
The LIFE COVID-19 Payment for each LIFE Organization is calculated by dividing the LIFE
Organization’s total amount reimbursed by the Department for LIFE program services in the first
quarter of calendar year 2020 by the total amount reimbursed by the Department of Human
Services (Department) for LIFE program services in the first quarter of calendar year 2020 to
obtain a specific quotient for each LIFE Organization. Each LIFE Organization’s quotient is then
multiplied by $10,000,000 to determine its LIFE COVID-19 Payment
OLTL is preparing for the distribution of the funds as one-time gross adjustments for ADS, PAS, and Res Hab services. Providers should expect to see the payment appear as a gross adjustment transaction/lump sum payment on a PROMISe remittance advice with payment issuance occurring nine days after the transaction appears on their remittance. OLTL’s intention is to distribute the payments in July. Payment information will be posted to the Department of Human Services’ website.
Providers do not need to submit requests for the funding. All currently enrolled providers that provided the above listed services and have a provider agreement for Waiver services and were in operation as of March 31, 2020 will receive the funding as described above.
Act 24 of 2020 requires these funds to be expended by November 30, 2020 or returned to the commonwealth. Additionally, these funds must be used for COVID-19 related expenses incurred between March 1, 2020 and November 30, 2020. Providers must keep documentation to prove that these funds were used for their response to the COVID-19 pandemic in case of an audit. Any person or entity accepting a COVID-19 payment agrees to provide documentation to the Department, upon request, for purposes of determining compliance with Act 24 requirements. Instructions on expenditure reporting will be provided in the future.
Providers are advised to review guidance for eligible expenses on the U.S. Department of Treasury website: