[Provider] Community Providers and DHHS Staff

[Provider Notification]

Attention: Community Providers and DHHS Staff

 

From:  Brenda M. Harvey, Commissioner

 

RE: Targeted Case Management Rules

 

Federal Update

 

            We have learned recently that there may be changes in the
Interim Targeted Case Management Rule when the final rule is published.
Based on a very large number of comments, CMS is rethinking the
requirement to bill in 15-minute increments.  While CMS will not allow
monthly billing, indications are that daily or weekly billing may be
acceptable and may be reflected in the final rules, due to be published
in August.  

 

CMS has also determined that the case management component of ACT
programs does not meet the strict definition of case management
articulated in the new rule.  Therefore, the integrity of this
evidence-based program will be maintained.  It is also important to note
that case management provided as part of a waiver program does not have
to comply with any part of the new rule until renewal date of the
waiver, though new waiver applications must demonstrate compliance with
the new rule.  

 

All of this assumes that there will not be a moratorium on these and
other new rules.  Even if such a moratorium becomes a reality, we will
continue the work of revising our case management rule and reorganizing
the services we provide under the rehabilitation rule.

 

State Update

 

            We will be submitting a State Plan Amendment regarding case
management services prior to June 30, 2008.  We will finalize our new
State TCM rule after the federal rule is finalized.  Until that time,
providers should plan to continue to bill as they have in the past.

            Groups that have been prohibited from billing by the terms
of the Interim Final TCM Rule will be allowed to continue to bill until
such time as that rule is final, most likely at the end of August.  This
includes education and corrections, as well as state employees who
provide case management services for children and adults in protective
services.  

This is a one-way communication.  Please do not respond to this message.

 

 

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