As anticipated, The Office for People With Developmental Disabilities (OPWDD) released interim guidance
on the new billing flexibility that takes effect from July 22, 2020 to October 14, 2020.
Most notable are the changes to program day duration. A full unit consists of two hours of service delivery and two allowable services. A half unit consists of one hour of service delivery and one allowable service.
Providers have a choice to use the new billing flexibility or the previous flexibility that allowed for non face-to-face services. Please pay close attention to this section to avoid any potential claims issues.
OPWDD conducted a webinar today to further discuss this guidance. We will share the PowerPoint and a link to the recording once it is available.
Some of the notable points made in the presentation included the following:
- Providers have 60 days from the date of the webinar to complete any claims adjustments related to the new billing flexibility.
- The Transaction Control Number (TCN) of the claim being adjusted must be referenced and the adjustment must be submitted in a new claim form with the adjustment field marked. The new revenue code must be referenced on the claims adjustment.
- The billing flexibilities can be used with Supplemental Group Day Habilitation (SGDH) and Day Habilitation Without Walls (DHWOW) services. Both services can be delivered remotely.
- The billing flexibilities cannot be used for day services provided within an Intermediate Care Facility (ICF).
- Providers need to coordinate with the person supported when determining the service delivery schedule. Providers are not necessarily tied to the day service delivery schedule that existed prior to the public health emergency.
- The COVID-19 addendum can continue to be used to update the Life Plan and Staff Action Plan through October 14, 2020.
OPWDD 20% Withhold on Local Assistance Funds
In our August 19 COVID-19 Update we addressed the forthcoming New York State Division of Budget (DOB) requirement that all state agencies implement a reduction (stated as a "withhold") of 20% of the next quarter payment for all state aid-funded programs.
On Monday, OPWDD published a memo
providing additional background leading up to the decision to implement the 20% withhold.
The Arc New York and other provider associations continue to discuss advocacy strategies in response to this situation. We will continue to provide updates as they become available, including discussion during our weekly call with the Executive Directors.
Safety Plan Posting Requirement
On July 15, the Interim Guidance Regarding the Reopening of Day Services Certified by the Office for People With Developmental Disabilities (Revised) was sent to all providers. Today, OPWDD provided additional instruction regarding the sharing of day service safety plans. Here is what OPWDD shared.
Individuals, families, other caregivers and Care Managers must be able to make decisions about each individual's participation in day services. To that end, each day service must consider individuals' specific needs and circumstances to ensure they are able to participate to the largest extent possible. In addition, OPWDD day services must provide access to the day service safety plans so appropriate parties are able to review the plan remotely and without the need to specifically request each plan from the agency. To accomplish that, agencies are to post copies of the safety plans for each of their day services on their website.
Please make your agency's plans available on your website by close of business September 4, 2020. For safety plans not yet developed, please post them to the website at the time of your submittal of the day service safety plan and attestation to OPWDD.
NYS Travel Advisory Update
Governor Cuomo announced the removal of five states from the travel advisory. Alaska, Arizona, Delaware, Maryland and Montana have been removed. Guam, a U.S. territory, has been added. Chapters should continue to review the list and advise employees of the current designated states. The current list can be found here.
Virtual Forum with Senator Carlucci Tomorrow
Tomorrow at 10 a.m. Senator David Carlucci will be hosting a virtual forum to discuss the impact of the COVID-19 pandemic on individuals with I/DD, their families and the providers that support them. The panel includes Al Kaplan, Senior Policy Advisor for AHRC NYC, Jane Zemon, Chief Program Officer for The Arc Rockland, as well as representatives from New York Disabilities Advocates (NYDA), Care Coordination Organizations and other advocates.
The conversation will be streamed via Facebook Live. Tune in to The Arc New York Facebook page
to watch the live stream, or check back at your convenience for the recording.