<html xmlns:v="urn:schemas-microsoft-com:vml" xmlns:o="urn:schemas-microsoft-com:office:office" xmlns:w="urn:schemas-microsoft-com:office:word" xmlns:x="urn:schemas-microsoft-com:office:excel" xmlns="http://www.w3.org/TR/REC-html40">
<head>
<META HTTP-EQUIV="Content-Type" CONTENT="text/html; charset=us-ascii">
<meta name=Generator content="Microsoft Word 11 (filtered medium)">
<style>
<!--
/* Style Definitions */
p.MsoNormal, li.MsoNormal, div.MsoNormal
{margin:0in;
margin-bottom:.0001pt;
font-size:12.0pt;
font-family:"Times New Roman";}
a:link, span.MsoHyperlink
{color:blue;
text-decoration:underline;}
a:visited, span.MsoHyperlinkFollowed
{color:purple;
text-decoration:underline;}
p
{mso-margin-top-alt:auto;
margin-right:0in;
mso-margin-bottom-alt:auto;
margin-left:0in;
font-size:12.0pt;
font-family:"Times New Roman";}
span.EmailStyle17
{mso-style-type:personal-compose;
font-family:Arial;
color:windowtext;}
@page Section1
{size:8.5in 11.0in;
margin:1.0in 1.25in 1.0in 1.25in;}
div.Section1
{page:Section1;}
-->
</style>
</head>
<body lang=EN-US link=blue vlink=purple>
<div class=Section1>
<p class=MsoNormal><b><font size=3 face="Times New Roman"><span
style='font-size:12.0pt;font-weight:bold'>Attention: Community Providers and
DHHS Staff<o:p></o:p></span></font></b></p>
<p class=MsoNormal><b><font size=3 face="Times New Roman"><span
style='font-size:12.0pt;font-weight:bold'><o:p> </o:p></span></font></b></p>
<p class=MsoNormal><b><font size=3 face="Times New Roman"><span
style='font-size:12.0pt;font-weight:bold'>From: Brenda M. Harvey, Commissioner<o:p></o:p></span></font></b></p>
<p class=MsoNormal><b><font size=3 face="Times New Roman"><span
style='font-size:12.0pt;font-weight:bold'><o:p> </o:p></span></font></b></p>
<p class=MsoNormal><b><font size=3 face="Times New Roman"><span
style='font-size:12.0pt;font-weight:bold'>RE: Targeted Case Management Rules<o:p></o:p></span></font></b></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
<p class=MsoNormal><u><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'>Federal Update<o:p></o:p></span></font></u></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> 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. <o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
<p class=MsoNormal style='text-indent:.5in'><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'>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. <o:p></o:p></span></font></p>
<p class=MsoNormal style='text-indent:.5in'><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'><o:p> </o:p></span></font></p>
<p class=MsoNormal style='text-indent:.5in'><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'>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.<o:p></o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'><o:p> </o:p></span></font></p>
<p class=MsoNormal><u><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'>State Update<o:p></o:p></span></font></u></p>
<p class=MsoNormal style='text-indent:.5in'><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=3 face="Times New Roman"><span style='font-size:
12.0pt'> 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.<o:p></o:p></span></font></p>
<p class=MsoNormal style='margin-top:12.0pt'><font size=3 face="Times New Roman"><span
style='font-size:12.0pt'> 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. <o:p></o:p></span></font></p>
<p class=MsoNormal style='margin-top:12.0pt'><i><font size=1 face=Arial><span
style='font-size:9.0pt;font-family:Arial;font-style:italic'>This is a one-way
communication. Please do not respond to this message.</span></font></i><o:p></o:p></p>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'><o:p> </o:p></span></font></p>
<p class=MsoNormal><font size=2 face=Arial><span style='font-size:10.0pt;
font-family:Arial'><o:p> </o:p></span></font></p>
</div>
</body>
</html>