A Little of This and A Whole Lot of That!

July 29, 2022

First,  DBHDS announced yesterday that the Governor had appointed a Chief Deputy Commissioner, Ellen Harrison, currently the Executive Director of Harrisonburg-Rockingham CSB.   Having experience as a service provider is always a positive for someone in a key position!   As Commissioner Smith said in his announcement:

“Ellen is currently the Executive Director at Harrisonburg-Rockingham Community Services Board, where for over six years she has managed 250 employees and a $17 million budget, implemented short and long-term strategic plans, and strengthened relationships with external stakeholders both locally and statewide. She was previously the CSB’s Director of Acute Services and also spent six years as the Director of Quality Assurance at Western State Hospital. Ellen has also held other positions within the regional CSB and private hospital system, and is a licensed counselor. Through these years of experience, Ellen gained the ability to conceptualize and implement programs that require large-scale integration and to lead multi-year system transformation efforts.”

with the considerable assistance from Jason Perkins, DMAS, we are still working or resolving the “revalidation” issues; when we have a plan we will also try to resolve the many questions about “cleaning up” the information stored in the MES system about each provider.  If it does not require “clean-up”, it at least needs explanation.

we have recently learned that the system for informing DMAS’ Provider enrollment of a new or renewed DBHDS License changed during the pandemic.   DBHDS stopped sending the letters indicating that a license had been extended pending finalization of the renewal.   We do not think that DBHDS informs DMAS at all.   Providers must notify DMAS by sending either a copy of the “letter” (and the license when received) or the renewed license via fax at 888-335-8476.  Keep a copy of the transmission verification as they do not acknowledge receipt.   And,

Fourth, we are still waiting for the details of the July 1, 2022 rates for the various community behavioral health, early intervention, and other services not specifically mentioned in the Budget #340 RRRR:

“Out of this appropriation, $56,640,476 from nongeneral funds the first year and $43,489,163 from the general fund and $64,983,275 from nongeneral funds the second year shall be provided, effective July 1, 2022, for the Department of Medical Assistance Services to increase rates by 12.5%, relative to the rates in effect prior to July 1, 2021, for: (i) adult day health care; (ii) consumer-directed facilitation services; (iii) crisis supervision, crisis stabilization and crisis support services; (v) transition coordinator services; (vi) mental health and early intervention case management services; and (vii) community behavioral health and habilitation services. In addition to the funds included in this Item, $38,057,684 the first year is provided for the state match for this purpose in Item 486 out of the revenues received from federal distributions of the American Rescue Plan Act of 2021. However, if ARPA funds cannot be used for this purpose the department is authorized to use the available cash balance or excess revenue in the Health Care Fund that is in excess of the estimates included for the first year in this act or additional general fund dollars in excess of the Official Medicaid Forecast made available due to changes in the federal match rate.  The department shall have the authority to implement these changes prior to the completion of any regulatory process undertaken in order to effect such change.”

Some services are specifically named, but (vii) is a “catchall” and we all apparently saw what we wanted to see; and it now appears that not all of the services which had received the temporary 12.5% increase will be included.  We hope to have the details and the confirmed rates by early next week.    We know that the administrative costs of adjusting claims, or delaying billing are considerable and it gets worse on a daily basis.