DD Waiver Implementation Update

October 22, 2016

We have submitted a “formal” ask for DMAS to extend the end date of the Group Home Residential service authorizations which migrated from IDOLs to WaMS and are to expire on 31 October.  Clearly when the plan was developed to ensure that providers continued to be paid and to allow some time to enter the billing code modifier which defines the licensed capacity of the home, DMAS believed that 61 days was sufficient to accomplish the task!  We were extremely appreciative for their efforts.

Between the initial problems caused by the lack of assignment of a “Tier” in the VaMMIS system which caused confusion and payment denials, and the multitude of issues caused by both the lack of instruction and the previously undetected systems issues with WaMS, there are now too many authorizations still incomplete and too few days between now and 31 October to complete all the tasks that need to be done.

The definitive instruction on how to properly enter service authorization requests into WaMS in a “if this, then do this” kind of format has been developed but has not yet been released by DBHDS.  We believe it will answer many of the questions, help providers identify those authorizations that will now have to be “fixed” behind the scenes, explain how to process those authorizations which can still be moved through the system, and give providers/CSBs a better understanding of how to enter the H2022 modifier for those which have not yet been touched.

We look forward to having a plan in place very soon to protect the billing for this service while we continue to try to resolve all of the issues which are both delaying implementation of new services and causing other revenue issues for a variety of providers for a variety of reasons.