A Couple of DMAS Updates

October 05, 2021

At a presentation to the HHR Joint Oversight Committee this afternoon, Karen Kimsey, Director of DMAS , announced that she expected the 12.5% rate increase to begin to be paid by the end of this month.  The delay has been due to their efforts to have the adjustment of claims back to July 1 be processed by the payor rather than requiring the providers to resubmit all claims to adjust to the higher rate. 

While we believe that is a fairly straight forward process for DMAS for all fee-for-service providers (DD Waiver), it is likely to be very complicated for the MCOs.  However, the reduction of the administrative burden for providers, will make the delay easier to accept!

On a related note, DMAS is still working on a reasonable solution for the conflict which has developed  between the expectation that face-to-face  visits should be taking place for Case Management and Service Facilitation and the family’s right to refuse when they are concerned that COVID still poses to high a risk for their medically compromised family members.  This has become a very difficult issue and we will continue to monitor.