SUPPORT COORDINATION DIVISION UPDATES
MAY 7, 2015
**Important Upcoming Training**
SUPPORTS PROGRAM MANDATED SC TRAINING – MAY 20TH HAMILTON TECH CENTER
The Division is poised to shift to a Medicaid-based, fee-for-service system and begin enrollment of individuals on to the Supports Program beginning this July. In light of this shift, we have added a full day training on the Supports Program, what it means to individuals using Interim Support Coordination services now, new graduates entering the system in June/July, and its impact on Support Coordination agencies to be held on:
Wednesday, May 20, 2015
10:00am – 4:00pm
Hamilton Technology Center
1200 Negron Drive
Hamilton, NJ 08691
(Directions Attached)
All Support Coordinators and SC Supervisors are welcome to attend. At least one representative from every SC agency is expected to attend.Please register to attend with name, SC agency, agency role, and contact information by emailing by Friday, May 15th.
In preparation for this training, you will want to begin reviewing the draft Supports Program Policies & Procedures Manual which was released today via our DDD Communications Listserv. If you did not receive this separate communication, send an email to to sign up for important announcements from the Division (separate from this SC Listserv which is only for SC agencies). The manual is attached to this email as well as the new Fee-for-Service Rate Schedule: Quick Reference Guide, with the new rates that will be effective in July for Division services. Please note that the new rates, including for Support Coordination, are not in effect until billing directly to Medicaid begins. Medicaid/DDD approved providers will begin submitting claims for and receiving reimbursement from Molina (Medicaid) at these rates as individuals are enrolled on the Supports Program over a 12-18 month time period. This information will be covered in more detail at the May 20th training.
PROCESS FOR REFERRAL TO CONTRACTED DAY PROGRAMS
Please be advised that the process for referring new graduates to contracted day programs in 2015 will be the same as last year. See attached for the 2014 process which remains in effect for 2015 graduates.
REVISED PAYMENT VOUCHER POLICY
A revised Payment Voucher Policy is attached. Please note that supporting documentation for payment vouchers must be uploaded to iRecord prior to submitting your claims for verification purposes. Hard copies of documents will no longer be accepted unless the agency no longer has iRecord access for that individual. In addition, billing cannot be done in advance, thus payment vouchers must reflect ISPs and end dates of Monitoring Tools that fall before the date the payment voucher is signed and turned in to the Division for payment. For example, late May end dates cannot be sent in now for payment. Fee-for-service means you bill after the fact, i.e. after the service is completed. We are aiming to speed up our internal processing for faster turnaround of payment vouchers, however, payment vouchers that are not in compliance with the Payment Voucher Policy, as revised today, will be returned and payment will be delayed.
DUPLICATIVE SERVICES POLICY
Please note the updated duplicative services policy as follows, which is in effect immediately:
The State cannot provide funding for duplicative services so adjustments must be made to individual budgets in situations where funding is being provided for day services through other State Agencies. Examples of these programs include but are not limited to Medical Day programs, Extended Employment programs, or Mental Health Partial Day Programs. In circumstances when an individual is accessing these duplicative services, the percentage of time – based on a 30 hour week – he/she is spending in the program that is not funded by the Division will be deducted from the employment/day component of the individual budget. For example, if someone is attending a Medical Day program for 15 hours per week, 50% of the employment/day component of his/her budget will be deducted. The remaining budget can be utilized to fund additional services as needed.
COMMUNICATION WITH MANAGED CARE ORGANIZATIONS (MCOs)
Please be advised that Support Coordinators are expected to liaison with MCOs and can do so without a release of information under the Treatment, Payment, and Health Care Operations clause of HIPAA. A link for your reference is provided below. It is best practice, however, to have a general HIPAA release signed by individuals upon admission to your agency that details that protected health information will be used for these purposes by third parties, such as the Division and MCOs involved in the individual’s care and service planning.
US Department of Health & Human Services Uses and Disclosures for Treatment, Payment, and Health Care Operations
1NJ Division of Developmental Disabilities