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Showing posts from June 26, 2016

Info about Private Insurance being Billed for Waiver Services

from DDRS:

Recently it was brought to the Bureau of Developmental Disabilities Services’ (BDDS) attention that some waiver participants are receiving coverage denial letters from their current or prior private insurance carriers for services provided under the Community Integration and Habilitation (CIH) or Family Supports (FS) waivers. This process does not impact eligibility for waiver services nor does it interrupt or have any other effect on existing waiver services. 
The Office of Medicaid Policy & Planning (OMPP) is sharing the below information to help clarify the billing activity taking place: Under federal law, state Medicaid programs are intended to be the “payer of last resort.” Therefore, Medicaid agencies are required to pursue third party reimbursements where third party coverage may be available to pay for a claim paid by Medicaid. In the Medicaid application, the applicant/member assigns their right of recovery from third party liabilities to the State and agrees to …

New Guidance Makes It Easier for Families of Children with Special Needs to get Medical Records

The Department of Health and Human Services (HHS) has issued new guidance on HIPAA (the Health Insurance Portability and AccountabilityAct.) This guidance will facilitate families of children with disabilities being able to obtain medical records, including waiving fees and sharing
with third parties if requested.

What Has Changed

Families of children with special needs have had difficulties accessing and sharing their child’s medical records due to costs or being unable to easily communicate with other providers. The National Partnership for Women and Families press release (see Resources) indicated that highlights of the guidance include:

 encouraging providers to give free copies of medical records to families

 posting charges for commonly asked medical records requests if applicable (e.g., for other providers)

 electronic copies of records available to families if requested

 “consumers can ask that their data be sent to ‘third parties,’ including consumer eHealth applications,…

Apply/Reapply for Caregiver Supports July 1 (info from DDRS)

from DDRS:

The Division of Disability and Rehabilitative Services, Bureau of Developmental Disabilities Services (BDDS) would like to announce that Caregiver Support Services funds will be available for the fiscal year 2017 beginning July 1, 2016. 
The purpose of Caregiver Support Services is to provide short-term relief for the primary caregiver to the extent state funds are available during fiscal year 2017 (i.e., July 1, 2016 –June 30, 2017). 
Caregiver Support Services may be approved and accessed to: 
 an individual that meets the state definition of Intellectual and Developmental Disabilities level of care and   the primary caregiver selects an eligible provider.   Please note: Caregiver Support Services will not be available to the primary caregiver if the individual is receiving or begins to receive similar services from any other State or Medicaid funded program. 
The Caregiver Support Services is 100 percent state funded and is available on a first-come, first-served basis. Prev…

DDRS Individual Experience Survey Results

The Division of Disability and Rehabilitative Services (DDRS) is pleased to present the final report from the Center on Community Living and Careers (CCLC), a center of the Indiana Institute on Disability and Community (IIDC) at Indiana University on the Indiana Individual Experience Survey (IES). DDRS contracted with CCLC to carry out this survey in response to the Centers for Medicare and Medicaid Services (CMS) Home and Community-Based Services (HCBS) rules issued in January of 2014. The report is available on the DDRS Announcements’ Web page

The IES is a part of a comprehensive assessment outlined in Indiana’s Statewide Transition Plan that DDRS is undertaking to determine Indiana’s level of compliance with the HCBS rules. The IES was designed to better understand the experiences of individuals who are receiving supports and services through the Community Integration and Habilitation (CIH) waiver and the Family Supports (FSW) waiver. 
The information gleaned from the IES is a crit…