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Florida AHCA Alert: ADT Daily Billing

 

Better Health Care for All Floridians

FLORIDA MEDICAID
A Division of the Agency for Health Care Administration

Florida Medicaid Health Care Alert
   September 2013


Provider Type(s): 67,  096,  098

Update to Billing Instruction Reminder

Developmental Disabilities iBudget Providers should bill according to the Individual Budgeting Waivers Provider Rate Tables.  For example, providers billing for services under procedure codes T2021UC or S5102UC must use hourly units of services, up to a maximum of 8 units per day.

Please disregard recent instructions regarding situations when the same number of units of service is provided daily on consecutive days, and completion of the date span using the “From—To Dates” dates of service.

A new claim line must be used for each day.

Please contact your local Medicaid Area Office for assistance with billing issues. Contact information for your local Medicaid Area Office may be found at http://mymedicaid-florida.com.

Home Care – Companionship Webinar Clarification from DOL

The Department of Labor (DOL) has scheduled five webinar sessions, one for each region of the country, on the new rules on home care / companionship services. DOL encourages participants to register for the webinar that is scheduled for the state where they live.

Thursday, October 3, 2013: Northeast Region (ME, NH, VT, MA, RI, CT, NY, PA, NJ, DE, MD, DC, VA, WV, PR) 3:00-4:30 Eastern Time
Tuesday, October 8, 2013: Western Region (AZ, NV, CA, OR, WA, ID, HI, AK) 10:00-11:30 Pacific Time
Thursday, October 10, 2013: Midwest Region (OH, MI, IN, IL, WI, MN, IA, MO, NE, KS) 1:00-2:30 Central Time; 2:00-3:30 Eastern Time
Tuesday, October 15, 2013: Southeast Region (KY, TN, NC, SC, GA, FL, AL, MS) 9:00-10:30 Central Time, 10:00-11:30 Eastern Time
Thursday, October 17, 2013: Southwest/Mountain Region (LA, TX, AR, OK, NM, CO, WY, UT, MT, ND, SD) 1:00-2:30, Mountain Time; 2:00-3:30 Central Time

More information is available at: http://www.dol.gov/whd/homecare/webinar.htm

 

We APPRECIATE You!

On behalf of all of our team at Therap, we just want to take a moment and say, Thank You! It is because of the 1200+ agencies across the country that Therap is the leader in electronic documentation for the developmental disability industry.

We couldn’t have gotten here without YOU! Icon of Wink

We APPRECIATE You!

Update – Change in Meeting Date: Provider Training: Medicaid Coverage & Prior Authorization for Applied Behavior Analysis Services

FLORIDA MEDICAID
A Division of the Agency for Health Care Administration

Health Care Alerts & Provider Alerts Messages
    May 2013


Provider Type(s): 05, 07, 16, 25, 26, 67, 68, 70, 71, 72, 77, 81 and 91  

Update – Change in Meeting Date
Provider Training: Medicaid Coverage & Prior Authorization for Applied Behavior Analysis Services

Provider training on “Medicaid Coverage & Prior Authorization for Applied Behavior Analysis Services” will be held on the dates and times listed below.  We will  provide guidance about Florida Medicaid policy for Applied Behavior Analysis services,  the prior authorization request process, and information  about service codes, reimbursement rates, and billing process.

This training session will be offered on Friday, May 17, 2013, at 10:00 a.m.ET and again onThursdayMay 30, 2013 at 1:00 p.m.ET.

To join the webinar on Friday, May 17, 2013, at 10:00 a.m., ET, please:

1. Dial: 1 (888) 670-3525 and at the prompt enter the Participant passcode 633 897 8710 then #

2. Go to: to

https://suncom.webex.com/suncom/k2/j.php?ED=178258682&UID=1372369707&HMAC=17138155dc0a0e0ce30ae5cdc38628fe18e8bbc3&RT=MiMxMQ%3D%3D

3. Enter your name and email address.

4. Enter the session password: This session does not require a password.

5. Click “Join Now”.

6. Follow the instructions that appear on your screen.

You don’t need to register or reserve space; just call and log-in at the designated time. The training will follow a PowerPoint presentation found at the Florida Medicaid Provider Training e-Library website.

To download the presentation to view during the webinar, please click on the “Upcoming Training and Schedules” tab, then right click on the hyperlink for the Training Presentation, choose “Save Target As…” and save a copy of the presentation to your computer.  You may also click on the hyperlink for the training presentation and view it online.

If you have any questions about the webinar, please contact elibrarytraining@ahca.myflorida.com

To join the webinar on ThursdayMay 30, 2013 at 1:00 p.m., ET, please:

1. Dial: 1 (888) 670-3525 and at the prompt enter the Participant passcode 633 897 8710 then #

2. Go to: to

https://suncom.webex.com/suncom/k2/j.php?ED=178259457&UID=1372378112&HMAC=f08e088d2d4644a1592020a7ec3b9137b4be3acc&RT=MiMxMQ%3D%3D

3. Enter your name and email address.

4. Enter the session password: This session does not require a password.

5. Click “Join Now”.

6. Follow the instructions that appear on your screen.
You don’t need to register or reserve space; just call and log-in at the designated time. The training will follow a PowerPoint presentation found at the Florida Medicaid Provider Training e-Library website.

To download the presentation to view during the webinar, please click on the “Upcoming Training and Schedules” tab, then right click on the hyperlink for the Training Presentation, choose “Save Target As…” and save a copy of the presentation to your computer.  You may also click on the hyperlink for the training presentation and view it online.

If you have any questions about the webinar, please contact elibrarytraining@ahca.myflorida.com.

 

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Florida APD will increase Planning and DD transition to Community Waiver Services

DD Waiver Waitlist Litigation Settled

Thursday, July 26, 2012

Dykes v. Dudek Settlement Agreement Summary

Disability Rights Florida filed the Dykes v. Dudek lawsuit in March of 2011 on behalf of individuals with intellectual and developmental disabilities who needed care, treatment, and habilitation and who were on the Waitlist for DD Medicaid Waiver services. Some of the plaintiffs resided in private ICF/DDs or nursing homes and some of the plaintiffs resided in their families’ homes. Many had been on the DD Waitlist for over five years.

The lawsuit sought to compel Florida to develop a reliable and accurate means of tracking and projecting service demand and associated trends in order to design and implement a comprehensive plan for the continued enrollment of over 21,000 persons waiting for DD Waiver services. In October of 2011, the court denied our motion to proceed as a class action and the case proceeded instead on the basis of our agency’s standing to sue and on behalf of the named plaintiffs.

On July 3, 2012, the lawsuit was settled. Under the settlement agreement the Agency for Persons with Disabilities (APD) and the Agency for Health Care Administration (AHCA) will engage in the activities described below. The agreement addresses five key areas:

1.    Individuals Residing in ICF/DDs and Nursing Homes

During 2011-2012 and 2012-2013, after the lawsuit was filed, the Legislature enacted budget proviso language allowing APD and AHCA to utilize current appropriations in the ICF/DD budget to fund transitions of persons in ICF/DDs to the DD Waiver. Two named plaintiffs successfully transitioned to community services and APD began transitioning other individuals. The agreement requires that APD request another year of this key proviso language. Moreover, APD will complete the process of contacting everyone on the DD Waitlist who resides in an ICF/DD and providing transition support to those desiring to move. APD will also provide choice counseling at annual reviews and every 6 months after during the Continued Stay Reviews. Previously, the Continued Stay Review form only required a review of the level of care for the continuation of ICF/DD services. Thus, residents will be made aware of the available options more frequently and have a more meaningful option to view alternative placements and have their choice documented. APD and AHCA will provide Disability Rights Florida with monthly progress reports regarding ICF/DD transitions.

Additionally, the agreement requires that AHCA request a similar mechanism from the Legislature to transition people with DD who reside in nursing homes to the DD Waiver. The named plaintiff from the lawsuit who resided in a nursing home has successfully transitioned and is now thriving in a small group home setting in the community.

2.    Crisis

Individuals approved for Crisis enrollment will receive DD Waiver-funded services within no more than ninety days from the determination of crisis. General revenue funds may continue to be used during the crisis application process. The ninety-day period is important because it ensures prompt enrollment on the DD Waiver as required by Medicaid law and greater certainty in the provision of needed DD Waiver services.

3.    Individual Family Support (IFS) Funds

APD will notice the development of a rule to govern utilization of IFS funds and the rule will include a uniform application to be used statewide. APD will also track the IFS services requested, the IFS amounts requested, and whether each request was approved or denied. This data will be provided to Disability Rights Florida. These changes should make the statewide process more fair and equitable. Moreover, by tracking the services and amounts requested, APD will have a more reliable and accurate means of tracking and projecting service demand.

4.    Waitlist Strategic Planning Workgroup

Each of the past few years, only 500-600 people were enrolled onto the DD Waiver and only if they qualified for crisis. To address this problem, the agreement requires APD to invite certain stakeholders (Self-Advocates, Family Care Council, DD Council, Centers for Independent Living, ARC, Disability Rights Florida, and others) to their Waitlist workgroup. The agreement outlines that the Waitlist Workgroup will consider developing ways to meet the needs of those waiting when it comes to housing, transportation, choice and community activities, investing in training for self-advocates, establishing peer connections, new training for Waitlist support coordinators, and a means of tracking and projecting service demand and associated trends.

5.    Employment

Many people waiting for DD Waiver services need waiver services to access long-term employment supports to obtain and maintain a job. Disability Rights Florida will be added to APD’s Employment workgroup. This workgroup is charged with designing a system to support the employment objectives of people with DD who are waiting for DD Waiver services.

During the coming months, if you or someone you know is waiting for services, it is possible to request that APD provide notification about the Waitlist category assigned. This notice must be requested. It is also possible to request reconsideration. Additionally, if you or someone you know needs assistance transitioning out of an ICF/DD, the APD Area/Regional office can be reached to provide a contact person and more information about the transition process.

Disability Rights Florida will continue to provide free and confidential services to individuals and be actively involved in monitoring the performance of the settlement agreement. Special attention will be placed on the stakeholder-developed comprehensive plan. Florida needs such a plan to meet the needs of those waiting for services as well as to continue the process of diverting and deinstitutionalizing those waiting in ICF/DDs or nursing homes. Over 3000 of the 21,000 people on the DD Waiver Waitlist live in an institution or are expected to need care in the next 12 months because of caregiver or behavioral issues. Another 209 report their caregiver as being over the age of 70. Moreover, approximately 115 people with DD on the Waitlist currently reside in nursing homes. We consider these to be urgent problems requiring a comprehensive plan developed by Florida’s stakeholders and we know you do too.

For more information, please contact Sylvia W. Smith, Director of Legislative and Public Affairs at Sylvias@disabilityrightsflorida.org.

DDNA Annual National Conference

The 2012 Conference began with the Pre-Conference on May 4th, with the Conference held May 5th – 7th. The Conference was held at the beautiful Rosen Plaza Hotel in Orlando, FL.   There was good attendance and it was an inspiring Conference which was opened by 10 year old girl who had a voice of a powerful angel.  This young girl was diagnosed with Autism and did not speak until she was 3 years old.  She thanked all the Nurses for the difference they make in the lives of children like her.  There wasn’t a dry eye in the room, including mine!

DDNA Annual National Conference pic

It was great having so many Nurses and others who are Therap Customers come over to our exhibit and say “Hello”!  I met so many wonderful, dedicated professionals and enjoyed sharing Therap Services with many interested folks across the Country!

I look forward to working with many new providers on reviewing and implementing Therap in their organizations and as always, supporting our faithful existing Therap Users to enhance their use, benefit and the further development of Therap Services for everyone!

 

More Cuts to Rates in Florida’s APD Budget

APD Continues Cost Containment Efforts

Tallahassee — On April 1, Agency for Persons with Disabilities (APD) will reduce the rates it pays for therapy assessments and all nursing services to the standard rate paid by the Medicaid State Plan. Currently, the APD Home and Community-Based Services Medicaid waiver pays higher rates for most of these services.

This rate change is the latest cost containment effort by APD to work toward bringing waiver expenses closer to the agency’s Legislative appropriation for the waiver.

The Legislature approved $810 million for APD’s Home and Community-Based Services Medicaid waiver for the 2011-12 state fiscal year that began on July 1. APD customers received $930 million worth of services last year.

While the agency is working to reduce Medicaid waiver expenditures, it is also looking for opportunities to increase waiver flexibility and equity for customers with the new iBudget Florida waiver. More than 3,000 APD customers in North Florida have transitioned to the new iBudget waiver which allows families to shift funding around to meet their current priorities.

APD annually serves more than 50,000 Floridians with developmental disabilities of autism, cerebral palsy, Down syndrome, intellectual disabilities, spina bifida, and Prader-Willi syndrome. The agency’s Medicaid waiver helps to support about 30,000 individuals with developmental disabilities so they may live and participate in their local communities. Those 30,000 people will all be transitioned to the new iBudget Florida waiver by July 2013.

For more information on iBudget, visit the website iBudgetFlorida.org.

For more information on the agency, call 1-866-APD-CARES or visit APDcares.org.

 

IPad Kiosks for Therap in Residential & Day Programs

Carolina Autism Supported Living Services in Charleston South Carolina has found a great way to use IPads in their group homes for documenting in Therap!  Here is a description and pictures from Phil Blevins, Executive Director:

 

“We used iPadWallBracket.com for the enclosure. There are many other sites with similar products but this seemed best for our purposes. We chose the enclosure that covers the “home” button. Then we installed a Kiosk program on the iPad. We chose Kiosk Pro from the Apple store. It’s free but there is a paid version with more features. We set the Therap login page as the start page and limited the kiosks browsing range to the therap domain. There are a few things I could note about setting it up if you ever want details.

We mounted the enclosure to a rolling laptop stand from Office Depot. Since it is plastic we chose not to drill holes in it but used a metal/plastic polymer adhesive to attach the enclosure.

We used iPads with WiFi instead of 3g so we have to make sure there is a working wireless router in the houses. And I’ve noticed that the iPad can’t handle the pop-up body image when entering skin/wound notes. But the staff person can still choose body parts from the drop-down menu. There may be other iPad quirks but we haven’t run into them yet.”
IPad Kiosks for Therap in Residential & Day Programs1      IPad Kiosks for Therap in Residential & Day Programs3  IPad Kiosks for Therap in Residential & Day Programs2

Therap National Conference – A Big Success!

Therap National Conference pic1In preparation for Therap Services pre-conference meetings on Monday, some of us came in early on Sunday to catch the Superbowl at a local Sports Bar-Redds, right across the street from the Met-Life Stadium where the Giants and Jets play!  It was sweet victory for New York and very exciting to be in the middle of it all!

We had a great conference with around 350 attendees, 3 days of over 35 sessions including: Basic to Advanced User sessions, Provider Organizations Special Topic sessions and Brainstorming with Therap Programmers! 

Therap National Conference pic2

Of course, being New York, we always take a trip to “The City” and what a great time of eating pizza, walking around Manhattan to look at the sites!  

Therap National Conference pic3

                           Therap National Conference pic4   Therap National Conference pic5

If you missed it, you can still get to one of our Regional Conferences this year.  Check out when we are coming to a town near you!

      https://www.therapservices.net/conferences/

Charleston-Low Country to New Jersey-Garden State!

This week Kris Keppler, Therap Implementation and Training Specialist provided the staff training for Therap’s first customer in the Charleston, SC Area, Carolina Autism Supported Living Services!

Carolina Autism Supported Living Services! Visit them at http://www.casls.org

They specialize in supporting individuals and families related to Autism and providing ABA Services: Applied Behavior Analysis!

I met Kris in Charleston on Wednesday evening for dinner, walked old historic Charleston which is a fantastic city and then we did several Demos of Therap in the Region.  The response to Therap was Great!  I expect we will be seeing much growth in Therap around the area and State this year.  Here a few shots of the local area!

Charleston pic1Charleston pic2

Charleston pic3Charleston pic4