Arkansas Medicaid Health Care Providers – Developmental Alternative Community Services Waiver (DDS ACS) – 1915 ( c ) waiver

Provider Manual Update DDSACS-2-17

Page 5

TO: Arkansas Medicaid Health Care Providers – DDS Alternative Community Services Waiver (DDS ACS) – 1915 ( c ) Waiver

EFFECTIVE DATE: August 22, 2017

SUBJECT: Provider Manual Update Transmittal DDSACS-2-17

REMOVE / INSERT
Section / Effective Date / Section / Effective Date
200.000 / — / 200.000 / —
201.000 / 10-8-10 / 201.000 / 8-22-17
201.100 / 3-1-10 / 201.100 / 8-22-17
201.200 / 3-1-10 / 201.200 / 8-22-17
202.000 / 3-1-10 / 202.000 / 8-22-17
202.100 / 3-1-10 / 202.100 / 8-22-17
202.200 / 9-1-16 / 202.200 / 8-22-17
211.000 / 9-1-16 / 211.000 / 8-22-17
211.200 / 9-1-16 / 211.200 / 8-22-17
212.000 / 3-1-10 / 212.000 / 8-22-17
213.000 / 9-1-16 / 213.000 / 8-22-17
213.300 / 9-1-16 / 213.300 / 8-22-17
214.000 / 7-15-12 / 214.000 / 8-22-17
214.100 / 3-1-10 / 214.100 / 8-22-17
215.000 / 3-1-10 / 215.000 / 8-22-17
215.100 / 3-1-10 / 215.100 / 8-22-17
215.200 / 3-1-10 / 215.200 / 8-22-17
215.300 / 3-1-10 / 215.300 / 8-22-17
216.000 / 3-1-10 / 216.000 / 8-22-17
216.100 / 1-1-16 / 216.100 / 8-22-17
216.200 / 3-1-10 / 216.200 / 8-22-17
216.300 / 3-1-10 / 216.300 / 8-22-17
— / — / 216.400 / 8-22-17
217.000 / 3-1-10 / 217.000 / 8-22-17
217.100 / 3-1-10 / 217.100 / 8-22-17
217.200 / 3-1-10 / 217.200 / 8-22-17
218.000 / 3-1-10 / 218.000 / 8-22-17
218.100 / 3-1-10 / 218.100 / 8-22-17
219.000 / 3-1-10 / 219.000 / 8-22-17
219.100 / 3-1-10 / 219.100 / 8-22-17
219.200 / 3-1-10 / 219.200 / 8-22-17
220.000 / 9-1-16 / 220.000 / 8-22-17
220.100 / 3-1-10 / 220.100 / 8-22-17
220.200 / 3-1-10 / 220.200 / 8-22-17
221.000 / 9-1-16 / 221.000 / 8-22-17
221.100 / 3-1-10 / 221.100 / 8-22-17
222.000 / 3-1-10 / 222.000 / 8-22-17
223.000 / 3-1-10 / 223.000 / 8-22-17
223.100 / 3-1-10 / 223.100 / 8-22-17
230.000 / 9-1-16 / 230.000 / 8-22-17
230.100 / 3-1-10 / 230.100 / 8-22-17
230.200 / 9-1-16 / 230.200 / 8-22-17
230.210 / 3-1-10 / 230.210 / 8-22-17
230.211 / 3-1-10 / — / —
230.212 / 3-1-10 / — / —
/ —
230.213 / 3-1-10 / — / —
/ —
230.300 / 3-1-10 / 230.300 / 8-22-17
230.400 / 9-1-16 / 230.400 / 8-22-17
230.410 / 9-1-16 / 230.410 / 8-22-17
240.000 / 3-1-10 / 240.000 / 8-22-17
241.000 / 9-1-16 / 241.000 / 8-22-17
251.000 / 3-1-10 / 251.000 / 8-22-17
261.000 / 3-1-10 / 261.000 / 8-22-17
262.000 / 3-1-10 / 262.000 / 8-22-17
262.210 / 9-1-14 / 262.210 / 8-22-17

Explanation of Updates

Section 200.000, DDS Alternative Community Services (ACS) Waiver General Information, has been updated to reflect the name change to DDS Community Employment Supports (CES).
Section 201.000, Arkansas Medicaid Program Participation Requirements for DDS CES Waiver Program, has been updated to reflect the name change and to add information on reduction of provider’s maximum number of persons served.
Section 201.100, Providers of DDS ACS Waiver Services in Arkansas and Bordering States Trade Area Cities, has been updated to reflect the name change.
Section 201.200, Organized Health Care Delivery System Provider, has been updated to reflect the name change and to add information about subcontract financial accountability.
Section 202.000, Documentation Requirements, has been updated to reflect the name change.
Section 202.100, Documentation in Beneficiary’s Case Files, has been updated to reflect the name change.
Section 202.200, HCBS Settings Requirements, has been updated to remove some information.
Section 211.000, Scope, has been updated to reflect the name change and to add/remove other information.
Section 211.200, Risk Assessment, has been updated to add and remove information.

Section 212.000, Description of Services, has been updated to reflect the name change.

Section 213.000, Supportive Living, has been updated add and remove information and clarify existing information.

Section 213.300, Benefits to Supportive Living, has been updated to add and remove information and clarify existing information, particularly, with regard to levels (tiers) of support.

Section 214.000, Respite Services, has been updated to remove some information.

Section 214.100, Benefit Limits for Respite Services, has been updated to add, delete, and change information, with particular regard to levels (tiers) of support and maximum daily and annual rates.

Section 215.000, Supported Employment, has been updated to add new information and remove old information.

Section 215.100, Supported Employment Exclusions, has been updated to reflect the name change.

Section 215.200, Documentation Requirements for Supported Employment, has been updated to add information on Discovery Career Planning, Employment Path Services, and Extended Services.

Section 215.300, Benefit Limits for Supported Employment, has been updated to add details on Discovery/Career Planning, Employment Support Job Development, Employment Supports Job Coaching and Extended Services, and to remove old information.

Section 216.000, Adaptive Equipment, has been updated to add details on adaptive equipment and to clarify what the waiver covers regarding such. The Note has been removed.

Section 216.100, Adaptive Equipment: Vehicle Modifications, has been updated to remove old information and to clarify exclusions.

Section 216.200, Adaptive Equipment: Personal Emergency Response System (PERS), has been updated to remove old information, add new information, and clarify existing information.

Section 216.300, Benefit Limits for Adaptive Equipment, has been updated to include new information and remove old information regarding the maximum annual expenditure for adaptive equipment.

Section 216.400, Required Documentation for Adaptive Equipment, has been added regarding documentation of bids on modifying adaptive equipment.

Section 217.000, Environmental Modifications, has been updated to include information on sole-source funding of environmental modifications.

Section 217.100, Environmental Modifications Exclusions, has been updated to remove the Conditions note.

Section 217.200, Benefit Limits for Environmental Modifications, has been updated to add and remove information regarding annual expenditure limits.

Section 218.000, Specialized Medical Supplies, has been updated to prioritize the physician’s role in documenting or ordering specialized medical equipment and to add that the most cost-effective item will be considered first.

Section 218.100, Benefit Limits for Specialized Medical Supplies, has been updated to clarify the maximum annual allowance.

Section 219.000, Supplemental Support Service, has been updated to remove old information and replace “emergencies” with “unforeseen problems.”

Section 219.100, Supplemental Support Service Exclusions, has been deleted. This section is now marked Reserved.

Section 219.200, Supplemental Support Service Benefit Limits, has been updated to clarify the maximum annual allowance.

Section 220.000, Case Management Services, has been updated primarily to replace “levels” of support with “tiers” of support and to define the minimum requirement for service contacts.

Section 220.100, Transitional Case Management, has been updated to remove information.

Section 220.200, Benefit Limits for Case Management, has been updated primarily to add information on abeyance and clarify the age limits.

Section 221.000, Consultation Services, has been updated to add behavior analyst and to change references to “person” to “beneficiary.”

Section 221.000, Benefit Limits for Consultation Service, has been updated to clarify the maximum per-hour benefit limit.

Section 222.000, Crisis Intervention Services, has been updated primarily to define the maximum annual limit and clarify the age limits.

Section 223.000, Community Transition Services, has been updated primarily to clarify the point of eligibility and remove certain information regarding exclusions.

Section 223.100, Benefit Limits for Community Transition Services, has been updated to clarify the overall maximum annual allowance.

Section 230.000, Eligibility Assessment, has been updated to include an independent assessment as part of the comprehensive diagnosis and evaluation.

Section 230.100, Categorical Eligibility Determination, has been updated to reflect the name change of the waiver program.

Section 230.200, Level of Care Determination, has been updated to further define the level of care determination.

Section 230.210, Tiers of Support, has been updated to replace the term “levels” with “tiers” and to further define the areas of assessment.

Section 230.211, Pervasive Level of Support, has been removed/deleted.

Section 230.212, Extensive Level of Support, has been removed/deleted.

Section 230.213, Limited Level of Support, has been removed/deleted.

Section 230.300, Comprehensive Diagnosis and Evaluation, has been updated to reflect the name change of the waiver program.

Section 230.400, Person-Centered Service Plan, has been updated primarily to include information regarding independent assessment and monitoring of risk level and risk management strategies.

Section 230.410, Person-Centered Service Plan Required Documentation, has been updated to include information regarding independent assessment.

Section 240.000, Prior Authorization, has been updated to include to reflect the name change of the waiver program.

Section 241.000, Approval Authority, has been updated primarily to reflect the name change of the waiver program and replace references of “level” to “tier.”

Section 251.000, Method of Reimbursement, has been updated to reflect the name change of the waiver program.

Section 261.000, Introduction to Billing, has been updated to reflect the name change of the waiver program.

Section 262.000, DDS CES Waiver Procedure Codes, has been updated to reflect the name change of the waiver program and in some instances replace units of service “month” to “package.”

Section 262.210, Completion of CMS-1500 Claim Form, has been updated to reflect the name change of the waiver program.

The paper version of this update transmittal includes revised pages that may be filed in your provider manual. See Section I for instructions on updating the paper version of the manual. For electronic versions, these changes have already been incorporated.

If you have questions regarding this transmittal, please contact the Hewlett Packard Enterprise Provider Assistance Center at 1-800-457-4454 (Toll-Free) within Arkansas or locally and Out-of-State at (501) 376-2211.

If you need this material in an alternative format, such as large print, please contact the Program Development and Quality Assurance Unit at (501) 320-6429.

Arkansas Medicaid provider manuals (including update transmittals), official notices, notices of rule making and remittance advice (RA) messages are available for downloading from the Arkansas Medicaid website: www.medicaid.state.ar.us.

Thank you for your participation in the Arkansas Medicaid Program.

/s/ Rose M. Naff
Rose M. Naff

Director

Arkansas Medicaid Health Care Providers – Developmental Alternative Community Services Waiver (DDS ACS) – 1915 ( c ) waiver

Provider Manual Update DDSACS-2-17

Page 5