DADS issued two information letters.
CBA, ICMW, HCSSAs, and STAR+PLUS Waiver (SPW) Consumers Transferring into the CBA and ICMW Programs:
Some providers are concerned about documentation requirements for SPW consumers transferring into the CBA or ICMW programs. After consulting with HHSC, DADS confirmed that a STAR+PLUS HMO transfer packet for SPW consumers contains the necessary supporting documentation to justify the services authorized on the SPW ISP, even if the documentation isn’t recorded on the DADS forms previously identified in the letter. Download the two-page letter for more information.
HCS providers:
DADS informed HCS providers about changes recently adopted to Title 1 about the process by which allowable related-party hours are determined for Medicaid cost reporting purposes, and new fully-funded model wage rates, effective October, 1, 2009. An excerpt of the four-page letter:
New Requirements for Determining Allowable Hours for Related-Party Direct Care Staff for Medicaid Cost Reporting Purposes
Under the new rule language, for each direct care staff-type, except direct care trainer supervisors and direct care worker supervisors, HHSC will determine the hours per unit of service encompassed by the 90th percentile in the array of reported hours per unit of service for providers with no related parties for that staff-type. HHSC then compares this figure to the hours per unit of service for the staff-type assumed in the fully-funded HCS rate model, adjusted for the provider’s average Level of Need (if applicable for the service in question) during the reporting period. The greater of the two values is the maximum hours allowed to be reported on the Medicaid cost report for that staff-type when the hours reported include hours worked by a related party.
