Implementation Updates

Implementation Update #100 (1/28/13)

• CABHA Certification Update
  • CABHA Attestation Letter
  • Senate Bill 525--An Act Relating to Critical Access Behavioral Health Agencies
• Primary Care & Behavioral Health Referral Forms
• Referrals for Outpatient Behavioral Health Services
• Housing Specialist Role in DOJ Settlement
• Incident Reporting Reminders

Implementation Update #99 (7/9/12)

• Treatment of Information Made Confidential by N.C.G.S. §122C

Implementation Update #98 (7/3/12)

• Change in Provider Monitoring Tools
• Provider Endorsement Ends
• NC-TOPPS Enhancements & Changes
• SOC in 1915 b/c Waiver Environment
• Medicaid Recipient Eligibility Verification
• Auth Requests for Psychiatric Inpatient Acute Care
• CON for Free-standing Psychiatric Hospitals/PRTF
• Clarification Regarding Psychiatric Billing
• Extension for Provisionally Licensed
• Clarification of DHSR Good Standing Status

Implementation Update #97 (5/28/12)

• PRTF Inventory
• Outpatient BH Provider Audit/Investigations
• Innovations 1915c Waiver Amendment
• Extension of Current CAP-MR/DD Waiver
• Referral forms for Primary Care/Beh. Health
• Processing of TFC Claims for NCHC/EPSDT
• NCHC Claims for SAIOP
• Co-Pay Issues for NCHC Claims
• Office Relocations for PI/Finance/Hearings

Attachments

• Form 1: Behavioral Health Agency Request for Information
• Form 2: Referral to Behavioral Health Services
• Form 3: Behavioral Health Feedback to Primary Care

Implementation Update #96 (4/25/12)

• 1915 (b)/(c) Medicaid Waiver Expansion Update

Implementation Update #95 (3/15/12)

• 1915 (b)/(c) Medicaid Waiver Expansion

Implementation Update #94 (2/17/12)

• 1915 (b)/(c) Medicaid Waiver Expansion

Implementation Update #93 (11/21/11)

• NC Division of Medical Assistance - Program Integrity

Implementation Update #92 (11/10/11)

• CABHA Rules
• Extension of Current CAP-MR/DD Waiver
• Health Choice Claims Denial/Retro Auth.
• H Code Limits for Provisionally Licensed
• Resolution for IPRS & Medicaid Claims Denial
• Cardinal Innovations Health Plan
• Outpatient Behavioral Health Seminar
• Endorsement Time Frames Tripled

Implementation Update #91 (10/10/11)

Implementation Update #91 Summary (10/17/11)

The effective date for rate change should have been November 1 and not October 1, 2011.

• Notice of Rate Reductions
• Health Choice Transition
• Payment on Professional Crossover Claims
• Outpatient Behavioral Services Seminars
• E-Mail Updates on Medicaid Alerts

Implementation Update #90 (9/7/11)

• Enrolling Medicaid/Health Choice in CCNC/CA
• Changes in Behavioral Health for Health Choice
• New UR Guidelines for Residential
• Electronic Prior Approval Requests
• CAP-I/DD Policy for Exception/Extention
• CAP-MR/DD Waiver Slots/MFP Slots Update
• Guidance for Electronic Signatures
• Fraudulent Trends in Outpatient Services
• Reporting Provider Fraud & Abuse
• First Commitment Update
• CABHA Key Staff Changes

Implementation Update #89 (8/3/11)

Implementation Update #89 Summary (8/17/11)

• Medicaid Waiver Strategic Plan
• MH/DD/SAS Integrated Care Toolkit
• CABHA Monitoring
• Electronic Submission of Prior Authorization
• Quality of Care Update
• IRIS Updates for FY 2012
• Independent Assessment for CST
• Proposed Changes to Medicaid Policy 8C
• Clarification of NCCI & Enrollment
• Outpatient Billing "Incident to" a Physician
• Perception of Care Surveys
• CAP-MR/DD and MFP Slots
• Press Release on Health Care Fraud

Special Implementation Update #88 (7/26/11)

• Selection of LMEs to Participate in the 1915 b/c Waiver

Implementation Update #87 (7/13/11)

Implementation Update #87 Summary (7/13/11)

• Clarification of Unmanaged Outpatient Visits
• Provisionally Licensed Billing Extension/NCCI
• NCCI Update: Billing "Incident To"
• Requests for Non-Covered Services: ADATC
• Frequently Asked CABHA Billing Questions
• New CABHA Provider Affiliation Denial Code
• Changes in Medicaid PA and Due Process
• Peer Support Service Update
• Protocol for Out of State Placement/Enrollment
• NC-TOPPS Enhancements
• MH/SA & DD TCM Medicaid Audit Findings

Implementation Update #86 (4/6/11)
Summary Implementation Update #86 (4/20/11)

Training Requirements for Community Support Team, Intensive In-Home, Day Treatment and Mental Health/Substance Abuse Targeted Case Management

• Training for CST, IIH, DT, & MH/SA TCM
• Training Opportunity: MINT for New Trainers
• Endorsement Policy
• CABHA First Responder Responsibility
• Update to CABHA Letter of Attestation Process
• CST/IIH Team Leader Clarification
• Outpatient Codes, Limits, Referrals & PA NCCI Update
• Medicare & TPL Bypass for DA & PH
• VO: Advantage of Online Request Submission
• Due Process & PA Policy & Procedures

Attachments

• Child and Adolescent Day Treatment Training Requirements
• Intensive In-Home Training Requirements as of January 1, 2011
• Community Support Team Training Requirements as of January 1, 2011

Implementation Update #85 (2/9/11) Revised 2/24/11
Summary of Implementation Update #85 (3/2/11)

Update to article: Revision to Level III/IV Child/Adolescent Discharge/Transition Plan for Level III and IV.

• Implementation of the NCCI
• CABHA Electronic Commerce Requirements
• Auth/Billing prior to CABHA Enrollment
• CST, IIH, DT after January 1, 2011
• Endorsement Triple Time Frames
• CABHA: Changes of Ownership
• Billing "Incident to" the MD
• Revision to Level III/IV Discharge Plan
• FAQ Regarding MST Implementation
• 6-Hour PCT/Recovery Training elements
• Medicaid Policy Updates
• Prior Approval Additional Information Request
• CAP/MR-DD UR by LMEs FAX Numbers
• Supports Intensity Scale Update
• CAP-MR/DD Update: Self Direction
• T1999 Supplies for CAP-MR/DD
• Post-Payment Reviews by PCG

Special Implementation Update #84 (12/21/10) Revised

• CAP-MR/DD Utilization Review

Implementation Update #83 (12/6/10)
Summary of Implementation Update #83 (12/16/10)

• Peer Support Services Implementation
• FAQ on MH/SA TCM
• Outpatient Opioid Tx Documentation
• Behavioral Health Mobile Crisis Management
• VO Request Submission Update
• CST, IIH, & DT Claims after 12/31/10
• Consumer Transition Update
• Protocol for CABHA Personnel Changes

Implementation Update #82 (11/12/10)
Summary of Implementation Update #82 (11/23/10)

• CS Authorizations
• Authorization Reminder for: CST, IIH, DT, CS
• PRTF/In-Patient Authorization Request Forms
• Adverse Determination Notification Changes
• Additional SOC Training Site Added
• CTS, IIH, Day Treatment Training Requirements
• Utilization Review for CAP/MR-DD Services
• CAP/MR-DD Residential/Home Support Services
• Rules for CABHA Posted
• Performance Bonds for CABHAs
• Peer Support Service Status

Implementation Update #81 (10/8/10)

Selection of the Next LME to Participate in the 1915b/c Medicaid Waiver

Implementation Update #80 (10/5/10)
Summary of Implementation Update #80 (10/19/10)

• Update on Unmanaged Visits for Children
• Service Orders for MH/SA TCM
• VO ProviderConnect Reminders
• Level III/IV Independent Psych. Evaluations
• Accreditation of TCM Services
• MH/SA TCM Providers & NC-TOPPS
• NC-IRIS Update
• Self-Direction for CAP-MR/DD Supports Waiver

Special Implementation Update #79 (9/29/10)
Special Implementation Update #79 (10/1/10) Revised
Summary of Special Implementation Update #79 (10/8/10)

• CABHAs Providing MH/SA TCM
• CABHA Enrollment Seminars Sept./Oct
• FAQ for CABHA Enrollment
• Provider Contractual and Legal Responsibility
  for Safeguarding Records
• CABHA Transition Benchmarks
• CST, IIH, DT, CS Re-endorsement
• Endorsement Applications for CST, IIH, or DT
• CABHA Attestation Letters Update

Attachments

• Attachment 1 Medicaid /State-funded Consumer Discharge/Transition Plan
• Attachment 2 NC Health Choice Discharge/Transition Plan
• Attachment 3 Transition Worksheet
• Attachment 4 Letters to Providers (revised ) The following articles were revised from the original posting of September 29th:  The transition plan within the CABHA Transition Benchmark Article and the Provider Letter were revised. Prior Authorization and Billing for MH/SA TCM  was clarified.

Implementation Update #78 (9/8/10)
Summary of Implementation Update #78 (9/24/10)

• CAP-MR/DD Update
• Providers of TCM-IDD
• Update on TCM-MH/DD
• Medicaid Reimbursement Rate Update
• CST Revised Limits
• Medicaid Recipient Notifications
• LME UR Update
• UR Adverse Determination Letters
• CABHA Transition Data
• CABHA Business Ownership

Implementation Update #77 (8/3/10)
Summary of Implementation Update #77 (8/12/10)

• TCM for IDD
• Update on MH/SA TCM
• CABHA Monitoring
• CABHA Enrollment Workshop
• PA for Medicaid Funded Services in Durham & Eastpointe LMEs
• AMHC Authorization Changes to ECBH
• Update on New PA guidelines for Outpatient
• NC START Annual Report
• Income and Family Size Information
• MOA Update
• NEA Letter Update

Attachments

• Attachment 1 TCM
• Attachment 2 CABHA
• Attachment 3 Define Family Income
• Attachment 4 Notification of Endorsement

Implementation Update #76 (7/8/10)
Summary to Implementation Update #76 (7/15/10)

• Reporting provider Fraud and Abuse
• Changes to Administrative Requirements
• CAP-MR/DD Clinical Policy/Manuals & Technical Amendment Number One
• Direct Billing for I/DD TCM Providers
• Update on New PA Guidelines for Outpatient
• CABHA Transition Updates
• CABHA Review Process
• Medicaid Enrollment for CABHA Applicants
• Incident Response and Improvement System
• Community Support Team Providers

Attachments

• Attachment 1
• Attachment 2

Special Implementation Update #75 (6/30/10) Revised
Special Implementation Update #75 (6/29/10)
Summary of Special Implementation Update #75 (7/12/10)

A revision was made to article: Revised CABHA Letter of Attestation  Submission Process - see below:

In order for providers of CST, IIH, and Day Treatment to obtain CABHA certification on or before December 31, 2010 there must be benchmarks established to allow sufficient time for completion of the three stage review process.  Therefore, current providers of these three services that have not yet applied for CABHA certification, must submit a completed Letter of Attestation on or before August 31, 2010.   This deadline will provide adequate time for the DHHS to complete the desk review portion of the CABHA certification process by September 30, 2010. 

• Transition Timeframe for Full CABHA Implementation
• Revised CABHA Letter of Attestation Submission Process
• Update on Subcontracting between a CABHA and Provider Agencies
• Extension of Case Management Services under CSS
• Update on CST, IIH and Day Treatment Training Requirements
• CST Service Revised Rate and Effective Date
• CST Revised Authorization Limit and Effective Date

Attachments

• Attachment A: Child and Adolescent Day Treatment Training Requirements
• Attachment B: Intensive In-Home Training Requirements
• Attachment C: Community Support Team Training Requirements

Special Implementation Update #74 (6/7/10)

Selection of Next LME to participate in the 1915b/c Medicaid Waiver