COVID-19 Update
May 4, 2020

Medicaid Update on Telehealth
The New York State Department of Health (NYSDOH) has released an update to their March 23 "Comprehensive Guidance Regarding Used of Telehealth." The update can be found hereThe changes in the update include:
  • clarification regarding payment parity for telehealth and telephonic services;
  • additional details regarding billing and coding instructions, including POS and Modifier codes to use in each of the telephonic billing lanes;
  • clarification on definitions of telehealth, telemedicine and telephonic services,
  • clarification on billing rules for Article 28 services with a Professional Component;
  • revised billing rules for FQHCs to allow wrap payments for licensed practitioners providing services via telehealth or telephone;
  • clarification of requirements for Medicaid Managed Care Plans; and
  • additional links to other resources
They have also updated their Frequently Asked Questions (FAQs) on Telehealth. 
On Tuesday, May 5, 2020 from 10:30 AM to 12:00 PM, the Department of Health Office of Health Insurance Programs will host a webinar to review Comprehensive Guidance Regarding Use of Telehealth including Telephonic Services During the COVID-19 State of Emergency. You can  register for the webinar here .

This webinar will provide an overview of the guidance and cover frequently asked questions. Additional questions will be addressed by webinar participants, as time permits. A recording of the webinar will be also made available on the Department's website.

Billing for Services Delivered 
As we reported to the Executive Directors, the 80% Phase II retainer payment rate is delayed. In the meantime, Chapters should continue to bill for actual services  provided, such as Day Habilitaion  in IRAs for individuals enrolled in the Chapter's Day Habilitation program. Billing and documentation should be conducted in accordance with the Day Habilitation billing guidance. Do not wait to bill for these services, as this will be a critical source of cash flow until retainer payments for the period beginning April 16 can be developed and approved.

Other services being provided, such as services to individuals living at home with family, should also be billed and documented in accordance with the applicable billing guidance for Community Habilitation or Prevocational Services. Once retainer payments are approved, it is possible that combined revenue might actually exceed 100 percent, which would need to be addressed. However, cash flow is critical, and we advise not to wait to bill for actual services being provided and documented.  If you have questions, please contact John Kemmer

NYDA Federal Funding Call to Action and COVID-19 Proposals
New York Disability Advocates (NYDA) released a petition calling on the Federal Government to deliver additional funding to the State of New York to offset the revenue shortfalls caused by the COVID-19 pandemic. You can read the request and add your name to the call here. NYDA has also developed a  for a comprehensive COVID-19 Infection Prevention Program for I/DD Service Providers, as well as proposed COVID-19 emergency room discharge protocols and hospitalization discharge protocols for people who live in residential programs certified by the Office for People with Developmental Disabilities (OPWDD). 

COVID-19 Cyber Threat Resources
The Department of Health and Human Services (HHS) Office for Civil Rights (OCR) published several cyber threat resources for healthcare providers. A summary with links to the available resources can be found here. Please share this with you Chapter IT staff and those involved in HIPAA and HITECH security. 

This and all related updates will be cataloged on  The Arc New York COVID-19 Resource Page   for future reference. Please contact us if you have questions regarding any of this information.

Josh Christiana , Associate Executive Director for Quality, Compliance & Chapter Relations

This email was sent to:
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