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August 21, 2020
CMS Approval of Appendix K
As we discussed during our weekly call with the Executive Directors, the Centers for Medicare and Medicaid Services (CMS) has approved New York's request to amend Appendix K of the Office for People with Developmental Disabilities (OPWDD) 1915(c) Home and Community Based Services (HCBS) Waiver. The amendment continues to provide relief in several areas as approved in the April 7, 2020 application, while adding additional relief in areas such as day service delivery and billing flexibility in response to the sunsetting of the day services retainer program on July 21, 2020.
A copy of the signed CMS approval can be found here, and the amended Appendix K can be found here. There are a number of changes in Appendix K, but the primary modification of import to our Chapters is that:
- All Day Habilitation and Site-Based Prevocational services duration requirements for billing are half of the current duration requirements. Face-to-face service time needed to bill a full unit is now two hours minimum and a half unit is one hour minimum. This flexibility will sunset on October 14, 2020. Given that families and individuals are continuing to assess their willingness to return to day services during the ongoing pandemic, The Arc New York is recommending to OPWDD that these flexibilities continue beyond the published sunset date.
- Per OPWDD, the Day Hab billing time flexibility is retroactive to July 22, meaning that services provided back to July 22 may be billed using this flexibility, including previously billed claims for Day Hab, Community Hab delivered in lieu of Day Hab, and even Supplemental Day Hab. The previously billed claims may be voided and then re-billed using the new Day Hab time allowances. Chapters should evaluate whether re-billing for these claims using the new flexibilities would be beneficial. Chapters should not begin to void or adjust any claims until the written guidance on the billing flexibilities is published.
Further, The Arc New York will be meeting with OPWDD to discuss its interim guidance on these new billing flexibilities. We anticipate that OPWDD will be releasing guidance within the next week, and that this guidance will add to the flexibilities outlined in the Appendix K amendment.
We have been advised that OPWDD is planning a webinar next week to address questions and concerns. We will disseminate a link as soon as it is available.
Your Voice Matters Survey
The Arc New York has been working with the Stakeholder Policy Forum (SPF), a family group that began during the COVID-19 pandemic, to better understand the implications of the pandemic and related funding issues on the families and individuals we support. SPF created a survey with help from OPWDD to better inform policy makers with a picture of the collective day-to-day experiences of the people those policies impact.
The survey invites participants to share their personal story and answer a few questions about what that experience means to them. The survey is currently open, and SPF plans to report results the community in late September. Please share this opportunity to voice personal perspectives with your networks. The survey can be completed at https://tinyurl.com/nys-idd-story-survey.
OPWDD Memo: Voting Rights for Persons With Developmental Disabilities
In anticipation of the November 3 general election, OPWDD released an informational memo on assisting people with disabilities in exercising their right to vote. Please distribute this memo to all stakeholders involved with supporting individuals in the voting process.
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CONTACT:
Josh Christiana, Associate Executive Director for Quality, Compliance & Chapter Relations
This email was sent to:
- President Jack Kowalczyk
- Board of Governors
- Chapter Presidents
- Executive Directors
- Chief Operating Officers
- Chief Financial Officers
- HR Directors
- PR Directors
- Quality & Compliance Staff
- Joint Committee on Quality & Compliance
- Guardianship Coordinators
- State Office Staff
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