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New Hampshire House Passes First-In-The-Nation Legislation To End Payment of Subminimum Wages To People with Disabilities

New Hampshire House Passes First-In-The-Nation Legislation To End Payment of Subminimum Wages To People with Disabilities

Press  Release,  April 15, 2015
CONCORD, NH – Today the New

Hampshire House of Representatives passed SB 47. New Hampshire becomes the first state in the country to repeal statutes that permit employers to pay persons with disabilities less than the state minimum wage simply because they have a disability. SB 47 received unanimous bipartisan support in both the house and the senate.

“SB 47 is a historic policy statement that reflects the current approach to hiring persons with disabilities that has evolved since the 1940’s in New Hampshire – every person with a disability can be competitively employed with the right supports and right job match,” said Chris Rueggeberg, Policy Director for the New Hampshire Council on Developmental Disabilities. “Paying people with disabilities subminimum wages is not necessary or helpful for them to get a job. They can be hired on their merits and abilities,” added Rueggeberg.

SB 47 prime sponsor Senator Hosmer has hired people with disabilities at his AutoServ business for the past 20 years. “The people I hire improve the whole culture and working atmosphere for all my employees,” said Senator Hosmer. SB 47 repeals outdated statutes and outdated approaches to hiring persons with disabilities that date to 1949.  Employers in New Hampshire no longer pay persons with disabilities a subminimum wage. Sheltered workshops are closed. Disability rights organizations, rehabilitation professionals, persons with disabilities working at competitive wage jobs and their employers, the NH Labor Department, the NH Department of Health and Human Services, and Vocational Rehabilitation and Services for Blind and Visually Impaired in the NH Department of Education all worked to pass SB 47. “I’m very pleased that the House has approved SB 47.  Last year, when I discovered that it is was legal in New Hampshire to pay persons with a disability less than the minimum wage simply because of their disability I introduced legislation to study this issue. The
study committee that I chaired unanimously recommended legislation to ban this practice in New Hampshire, ”  said former State
Representative  Chris Muns.

The New Hampshire Council on Developmental Disabilities is a federally funded state agency that supports public policies and initiatives that remove barriers and promote opportunities in all areas of life. The Council carries out its mission through education, advocacy and the funding of innovative projects that make a difference in people’s lives. Find out more at http://www.nhddc.org.

By |2016-11-03T10:01:44+00:00April 20th, 2015|Categories: Uncategorized|Tags: , , , , , , , , , , , , , , , , , |Comments Off on New Hampshire House Passes First-In-The-Nation Legislation To End Payment of Subminimum Wages To People with Disabilities

Florida Medicaid Fee-for-Service Monitoring

AHCA Logo

 

Better Health Care for All Floridians
FLORIDA MEDICAID
A Division of the Agency for Health Care Administration
Florida Medicaid Health Care Alert
February 2015

Provider Type(s): 08, 23, 81, and 67

Medicaid Fee-for-Service Monitoring

Monitoring is being conducted to provide feedback to providers regarding their adherence to Medicaid requirements for recipients who are not enrolled in a Medicaid managed care plan.

The Medicaid Fee-for-Service Monitoring Unit has begun conducting monitoring reviews of service providers for the following programs:

  • Adult Cystic Fibrosis (ACF) Waiver
  • Model Waiver
  • Project AIDS Care (PAC) Waiver
  • Traumatic Brain Injury and Spinal Cord Injury (TBI/SCI) Waiver
  • Early Intervention Services (EIS)
  • Certified School Based Services Match
  • Medical Foster Care (MFC)

Providers will be contacted by telephone or e-mail for notification of the date of review and will receive a letter detailing the documentation the Monitoring Unit will review. A copy of the monitoring tool, based on state and federal Medicaid policy, for the specific service will accompany the letter.  After the review, a monitoring report/summary will be sent to the provider.

Medicaid Provider Agreement (5)(e) and section 409.907(3)(e), Florida Statutes, requires Medicaid providers to send, at the provider’s expense, all Medicaid-related information, which may be in the form of records, logs, documents, or computer files, and other information pertaining to services or goods billed to the Medicaid program, including access to all patient records to the Agency for Health Care Administration, Attorney General, or Federal Government entity.

LINKS

Florida Medicaid Web Portal | Florida Medicaid Health Information Network | Florida Medicaid HIPAA Information | HIPAA Transactions & Code Sets Standard | National Provider Identifier Standard (NPI) | Florida Medicaid EHR Incentive Program | FloridaHealthFinder.gov

QUESTIONS ABOUT FLORIDA MEDICAID?

Please direct questions about Medicaid policies to your local Medicaid field office. The Medicaid field offices’ addresses and phone numbers are available on the Field Offices Web page.

ALERTS INFORMATION

The Florida Medicaid program has created an e-mail alert system to supplement the present method of receiving Provider Alerts information and to alert registered subscribers of “late-breaking” health care information. An e-mail will be delivered to your mailbox when Medicaid policy clarifications or other health care information is available that is appropriate for your selected area and provider type.

Visit the Florida Medicaid’s Health Care Alerts page to subscribe now. You may unsubscribe or update your subscription at any time by clicking on the “Manage your subscription” icon in the footer of each e-mail. Other questions regarding the e-mail alert system can be sent to the Florida Medicaid Alerts Administrator.

© 2015 Agency for Health Care Administration

 

Court Ruling Related to the DOL Companion – Home Care Rule

This is a follow up to the DOL emails we sent earlier today.  After consideration of the parties’ pleadings, the arguments of counsel and relevant law, and the entire record in this case, plaintiffs’ motion for a partial summary judgment is GRANTED, defendants motion is DENIED, and the Department of Labor’s Third Party Employer regulation scheduled to go into effect on Jan 1, is VACATED.  See below for a summary on the decision.

The United States District Court for the District of Columbia has today issued a partial summary judgment on two pieces of a lawsuit filed by the Home Care Association of America and other plaintiffs related to the Department of Labor’s Home Care Rule. Please note that this information is not legal advice, and is shared after a swift and preliminary review of the decision.

The decision notes that after consideration of the parties’ pleadings, the arguments of counsel and relevant law, and the entire record in this case, plaintiffs’ motion for a partial summary judgment is GRANTED, defendants motion is DENIED and the Departments Third Party Employer regulation scheduled to go into effect on Jan 1, is VACATED.

The largest area implicated by this decision is the third party employer regulation, which withdrew the availability of the companionship and live-in caregiver exemptions from third parties.

Companionship Exemption

As you know, the companionship exemption was impacted in two important ways by the Home Care rule. First, the rule established that the companionship services exemption is not applicable when the employee spends more than 20 percent of his or her workweek performing care services. This portion of the regulation is NOT impacted by this decision, so the companionship exemption is available only when this percentage test is met.

Second, the rule set forth that the companionship exemption is not available to third party employers. This portion of the rule, called the Third Party Employer regulation, is impacted by this court decision by allowing third party employers to avail themselves of the exemption. This means that, for situations meeting the definition of and test for companionship, workers can receive straight pay, not overtime for work over 40 hours/week even when there is a third party employer.

Live in Exemption

Like the Companionship exemption, the DOL rule removed the availability of the live-in caregiver exemption from third party employers. This ruling allows third parties to utilize the exemption, enabling straight pay for live-in caregivers, including for those hours worked over 40.  For details on what constitutes a “live-in” domestic service worker and other conditions of the exemption, see Fact Sheet #79B: Live-In Domestic Service Workers Under the FLSA. http://www.dol.gov/whd/regs/compliance/whdfs79b.htm

While this is decision is important, this case has not been fully decided (there are other counts to be considered by the court) and there will likely be appeals filed, even on this limited judgment.  As a result, states should remain vigilant in their planning and budgeting in the event that, at the conclusion of these legal proceedings, the original rule will be in full force and effect.

NASDDDS will continue to closely monitor developments and keep you apprised.

To read the court’s decision, visit:

https://ecf.dcd.uscourts.gov/cgi-bin/show_public_doc?2014cv0967-21

 

Florida APD Reposted Requests for Information (RFI)

The Agency for Persons with Disabilities has reposted Requests for Information (RFI) to seek input on models the State of Florida may want to consider as it addresses.  The first announcement included wrong links.  Sorry for any inconvenience.  The four RFIs are available at:

 

 

 

 

 

Details of each RFI are posted to the State of Florida Vendor Bid System –http://www.myflorida.com/apps/vbs/vbs_www.main_menu .

 

 

Agency for Persons with Disabilities

4030 Esplanade Way

Tallahassee, FL 32399

www.APDCares.org

Home and Community-Based Services Settings Rule Training Sessions

Florida Medicaid Health Care Alert
July 2014

Provider Type(s): 05, 67, and 76
Home and Community-Based Services Settings Rule Training Sessions
The Agency for Health Care Administration (Agency) will conduct regular training session for individuals, providers and interested stakeholders on the federal Home and Community-Based Settings Rule.
The Agency has scheduled a session for:

Tuesday, July 15, 2:00 pm ET
To join the training session

1. Call-in toll-free number: 1-888-670-3525 (US) then enter attendee access code: 250 928 7551 #
2. Click on this link: Home and Community Based Settings Rule and Transition Planning.

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.

For further information, please visithttp://ahca.myflorida.com/Medicaid/hcbs_waivers/index.shtml or contact Sophia Whaley at

1 (850) 412-4284 or email .Sophia.Whaley@ahca.myflorida.com

HCBS Settings Rule

In March 2014 the Centers for Medicare and Medicaid Services (CMS) issued a final rule for home and community based programs. The rule requires the Agency to provide an opportunity for the public to comment on substantive changes to home and community based service waiver programs and to ensure persons who receive Medicaid home and community based services do so in and environment, and from providers who:

  • Involve them in the care planning process;
  • Help them to be active in the community;
  • Provide a home-like environment if a person lives in a group home, assisted living facility or adult family care home; and
  • Enable them to make personal choices.

We have developed a preliminary transition plan detailing the steps to be taken to implement the new rule.  The preliminary transition plan contains the following information:

  • An overview of the federal rule;
  • Planned transition activities;
  • A timeline for when the comprehensive transition plan will be developed;
  • Impending waiver amendments and renewals; and
  • Details on the public comment process.

The final comprehensive transition plan will be available for public comment in the fall of 2014.

The preliminary transition plan is available for public comment from June 25th 2014 until July 25th 2014. Comments within this time period may be sent to:

FLMedicaidWaivers@ahca.myflorida.com
OR
Agency for Health Care Administration
Attention: HCBS Waivers
2727 Mahan Drive, MS#20
Tallahassee, FL, 32308

Therap Services Announces U.S. Patent Issuance for Secure Electronic Reporting of Abuse or Neglect for I/DD Provider Agencies

WATERBURY, Conn., June 18, 2014 /PRNewswire/ — Therap Services, leader in electronic documentation software for Intellectual Disability and Developmental Disability Service Providers, has received U.S. Government Patent No. 8,739,253 B2 for Managing Secure Sharing of Private Information Pertaining to Abuse or Neglect Across Security Domains on May 27, 2014.

Justin Brockie, Therap Services COO, states: “The award of this patent again confirms Therap’s status as the software leader in the intellectual disability community.  States and providers using Therap have shown the benefits of our approach to secure transparency and real time sharing.  These approaches can have a direct impact on the systems that support people with disabilities and prevent abuse, neglect and exploitation.”

Therap’s patented application for secure sharing of private information pertaining to abuse or neglect includes granting a staff user from one agency (such as an Oversight Agency) the ability to access private information stored within a secondary Provider Agency account when access authorization is in place through assigned caseloads and permissions. This method ensures that staff members are able to securely access private information based on ‘need to know’.

Therap Services applications and certified Electronic Health Record (EHR) provide the documentation components needed by Intellectual Disability and Developmental Disability Service Agencies to maintain their focus while adapting to a changing environment within the Human Services industry.  State and federal agencies and standards, including CMS and HIPAA, mandate strict requirements on accurately tracking incidents, including those reports of abuse and neglect and prevention of Medicaid fraud. Therap’s customers can complete and monitor documentation efficiently across secure domains, enabling them to focus on providing higher quality services to individuals with intellectual and developmental disabilities.

Therap’s applications are utilized across disciplines in the I/DD field per the CMS home and community-based services (HCBS) requirements. Therap applications include over 70 modules ranging from documentation of service provision through a daily note, to person centered planning tools, incident report management, health assessments and individual care plans, an electronic MAR integrated with an industry-standard drug database, an individual referral process for state and multi-provider systems, a comprehensive report library for internal and external audits, to electronic billing direct to Medicaid through a secure, HIPAA 5010-compliant method.

About Therap Services, LLC

Therap Services’ certified EHR and documentation software solution are utilized by over 220,000 users in 1300 Intellectual Disability and Developmental Disability Provider Agencies. Use of Therap Services is mandated by 5 state governments. Therap’s software solution is used in home and community-based services (HCBS), intermediate care facilities for the developmentally disabled (ICF-DD) and other settings to document waiver service provision, employment supports, case management, incident reporting, management of staff training records and for electronic billing claim submissions directly to Medicaid. Therap Services is HIPAA OMNIBUS ACT of 2013 compliant. Learn more at www.therapservices.net.

 

 

South Carolina Providers meet In Myrtle Beach

Last week, February 1oth, 2014 the SC Human Services Providers Association met in Myrtle Beach.  The opener on 2/10 included a Therap User Group session for South Carolina Therap Users.  Chelsea Newby, Training and Implementation Specialist with Therap was there to share her knowledge and answer questions.  It was great to have staff participate from  UCP of South Carolina, Colleton County DSN Board, Georgetown DSN Board, Verizon Wireless and others.

The Conference had an Opening Plenary Session with Dr. Beverly Buscemi, DDSN State Director who shared the state of the state!

The Conference ended a day early due to winter weather coming to South Carolina for the next couple of days.   This turned out to be a very good decision South Carolina was in a State of Emergency for the following 3 days due to ice and very dangerous road conditions.

We left Myrtle Beach at Noon and by 2:30 the Highway 20 & 77 around Columbia were covered in snow and sleet.  By the time we got to Fort mill, we had winter weather and quite a snow storm for the south over the following 24 hours.

Here is what we had coming down the next morning!

 

 

Florida Statewide Medicaid Managed Care Program – Webinar 1/21/14

The Agency for Health Care Administration invites you to participate as an attendee in the following online training session:

Topic: SMMC: Developmental Disabilities Webinar
Host: The Agency for Health Care Administration
Date: Tuesday, January 21, 2014
Time: 11:00 am, Eastern Standard Time (New York, GMT-05:00)
Session number: 643 551 021
Session password: This session does not require a password.

——————————————————-
To join the training session
——————————————————-

1. Go to https://suncom.webex.com/suncom/k2/j.php?ED=259209702&UID=1732291422&HMAC=7e63c53a351f9355a3cc5729dd8669f01089473c&RT=MiMxMQ%3D%3D
2. Enter your name and email address.
3. Enter the session password: This session does not require a password.
4. Click “Join Now”.
5. Follow the instructions that appear on your screen.

To view in other time zones or languages, please click the link
https://suncom.webex.com/suncom/k2/j.php?ED=2592…

AHCA Alert-ABA for Children under 21

Florida Agency for Health Care Administration

Better Health Care for All Floridians

 

FLORIDA MEDICAID
A Division of the Agency for Health Care Administration

Florida Medicaid Health Care Alert
January 2014


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

Revised Alert for Developmental Disabilities Home and Community Medicaid Waiver Providers:  Medicaid Coverage and Prior Authorization of Applied Behavior Analysis for Children Under 21 with Autism Spectrum Disorder

This alert includes information for Developmental Disabilities Home and Community Medicaid waiver providers. Information for other qualified provider types can be found in the applicable provider alert. This revised alert supersedes the information specific to Developmental Disabilities Home and Community Medicaid waiver providers in previous alerts posted on 4/2/12, 4/17/12, 5/17/12, 6/15/12, 7/6/12, and 9/6/12.

This alert describes provider qualifications, recipient eligibility criteria, the prior authorization request process, service codes and reimbursement rates, the billing process, place of service codes, and instructions for managed care plans. These services require prior authorization.

Provider Qualifications:

ABA services described in this alert must be rendered by Certified behavior analyst (CBA) and certified associate behavior assistant (CABA) providers who meet the qualifications outlined in 65G-4.003 of the Florida Administrative Code, are enrolled as Medicaid waiver providers through the Developmental Disabilities Home and Community Medicaid waiver programs and have received prior authorization from Medicaid for the service.

Recipient Eligibility Criteria:

Qualified treating practitioners may render medically necessary ABA to children under 21 years old having any of the following ICD-9 diagnosis codes:  299, 299.0, 299.00, 299.01, 299.1, 299.10, 299.11, 299.8, 299.80, 299.81, 299.9, 299.90, or 299.91.

Prior Authorization Request Process:

ABA services must be prior approved by Medicaid.  If a physician determines that a Medicaid eligible child diagnosed with an autism spectrum disorder needs Applied Behavior Analysis (ABA), the provider must submit a request to the Medicaid area office. The following information must be included:

  1. Recipient name, date of birth, Medicaid ID, and current mailing address.
  2. Requesting provider name, national provider identifier, address, and telephone and fax numbers.
  3. Diagnosis of recipient and diagnosis code.
  4. If already assessed, expected duration of ABA treatment.
  5. The primary focus of ABA treatment.
  6. Medical records that document the diagnosis of autism spectrum disorder.

An optional form for this purpose is available online at the Child Health Check-Up web page. This optional prior authorization form has been revised effective January 10, 2014.Prior authorization documentation as described above must be submitted to the recipient’s Medicaid area office. Contact information for the area offices can be found on the Public Provider Web Portal.

Service Codes and Reimbursement Rates:

Instructions for Developmental Disability Waiver Providers
to Bill Fee-For-Service for Non-Waiver Recipients

ABA services must be prior approved by Medicaid. Providers should consult the Medicaid Developmental Disabilities Waiver Services Coverage and Limitations Handbook for provider qualifications and documentation requirements (requirements for review of documentation by a Local Review Committee and submission of documentation to the waiver support coordinator do not apply). Billing for ABA services in a group setting is not allowable. A total of up to 160 quarter-hour units per week of combined service may be authorized. Eligible service codes and rates of reimbursement for Applied Behavior Analysis services are:

Description of
Service

Procedure
Code

Modifier
1

Modifier
2

Rate

Limits

Assessment Services
Behavior Analysis Assessment for Autism

H2020

UD

$299.85 per assessment

One assessment per state fiscal year

Treatment Services
Behavior Analysis Level 1 for Autism

H2019

UD

HP

$19.05 per quarter hour

Maximum combined daily limit of up to 32 quarter-hour units
Maximum combined weekly limit up to 160 quarter-hour units of all treatment services

Behavior Analysis Level 2 for Autism

H2019

UD

HO

$16.64 per quarter hour

Behavior Analysis Level 3 for Autism

H2019

UD

HN

$10.35 per quarter hour

Behavior Assistant Services for Autism

H2019

UD

HM

$4.31 per quarter hour

 Instructions for Developmental Disability Waiver Providers
for Waiver Recipients

Scenario Coverage
Existing DD waiver recipient receives ABA waiver services APD continues to cover these ABA hours through the waiver.
Existing DD waiver recipient receives ABA waiver services but requests an increase in services APD reviews the request to determine if additional hours are medically necessary. If yes, then APD will cover the additional hours through the waiver. If no, then the recipient may request authorization to receive ABA through the state plan.
Existing DD waiver recipient, who does not receive ABA services, requests ABA APD reviews the request to determine if additional hours are medically necessary. If yes, then APD will cover the service through the waiver. If no, then the recipient may request authorization to receive ABA through the state plan.
Individual on the DD waiver waiting list who is Medicaid eligible applies for the waiver through the crisis process. ABA is one of the identified service needs. APD will refer the individual to the ABA state plan authorization process for coverage of ABA.
Individual on the DD waiver waiting list who is Medicaid eligible and requests ABA services. APD will refer the individual to the ABA state plan authorization process for coverage of ABA.

Billing Process:

To bill for the services, providers must submit claims in accordance with the Provider Reimbursement Handbook, CMS-1500 located on the Provider Handbook page of the Public Provider Web Portal. All claims for ABA services for children with autism spectrum disorders must be billed fee-for-service, even for those recipients enrolled in a Medicaid managed care plan. When billing for services for treatment of autism spectrum disorders, the claim must include one of the following primary diagnoses: 299, 299.0, 299.00, 299.01, 299.1, 299.10, 299.11, 299.8, 299.80, 299.81, 299.9, 299.90, or 299.91. Enter “1” for the diagnosis code reference number (pointer) to relate the procedures performed to the primary diagnosis.

Billing is allowed for dates of service beginning with the date of prior authorization.

DO NOT SEND any attachments or medical records to the Medicaid fiscal agent with the CMS-1500 claim form. Regardless of place or dates of service, attachments for Applied Behavior Analysis are not required. All CMS-1500 claims for Applied Behavior Analysis services for children with autism spectrum disorders will be processed per these instructions.

Place of Service Codes:

Services must be billed using the correct place of service code for the location of the service provided. These services may be provided in the provider’s office, the recipient’s place of residence or anywhere in the community. However, in all cases, behavior analysis services must also be provided in the setting(s) relevant to the behavior problems being addressed.

The following place of service codes should be used by DD Waiver Providers when submitting claims (see page 2-22 of the Developmental Disabilities Waiver Services Coverage and Limitations Handbook):

11 – Office
12 – Home
13 – Assisted Living Facility
14 – Group Home
49 – Independent Clinic
53 – Community Mental Health Center
99 – Other Place of Service

Place of service code “99 – Other Place of Service” is not acceptable except for unusual circumstances that are documented in the recipient’s treatment or service plan, or in the recipient’s treatment notes.Medicaid will monitor providers who frequently utilize place of service code 99.

Instructions for Managed Care Plans:

Managed care plans are not currently required to authorize or cover Applied Behavior Analysis Services for the treatment of autism spectrum disorders. If a child enrolled in a Medicaid managed care plan requires ABA services, the plan may refer the recipient to any of the identified qualifying providers to receive the service under Medicaid fee-for-service. Alternatively, the managed care plan may refer the recipient to the Medicaid area office for assistance with finding a qualified provider. Managed care plans must share information on how to access ABA services with their contracted community behavioral health and physician providers.

Other Key Information:

For questions, contact your local Medicaid area office. Contact information for the area offices can be found on the Public Provider Web Portal.

 


 

LINKS

Florida Medicaid Web Portal | Florida Medicaid Health Information Network | Florida Medicaid HIPAA Information | HIPAA Transactions & Code Sets Standard | National Provider Identifier Standard (NPI) | Florida Medicaid EHR Incentive Program | FloridaHealthFinder.gov


QUESTIONS ABOUT FLORIDA MEDICAID?

Please direct questions about Medicaid policies to your local Medicaid area office. The Medicaid area offices’ addresses and phone numbers are available on the Area Offices Web page.


ALERTS INFORMATION

The Florida Medicaid program has created an e-mail alert system to supplement the present method of receiving Provider Alerts information and to alert registered subscribers of “late-breaking” health care information. An e-mail will be delivered to your mailbox when Medicaid policy clarifications or other health care information is available that is appropriate for your selected area and provider type.

Visit the Florida Medicaid’s Health Care Alerts page to subscribe now. You may unsubscribe or update your subscription at any time by clicking on the “Manage your subscription” icon in the footer of each e-mail. Other questions regarding the e-mail alert system can be sent to the Florida Medicaid Alerts Administrator.

 

© 2014 Agency for Health Care Administration

 

 

This message was sent from Florida Agency for Health Care Administration tocswilley@floridaarf.org. It was sent from: Florida Agency for Health Care Administration, 2727 Mahan Drive Tallahassee, FL 32308. You can modify/update your subscription via the link below.

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!