Monday Morning and News to Share

November 23, 2020

We have posted our  Legislative Plan for 2021 for the coming Session; over the next week or two we will develop a list of talking points for you to use with your Delegates and Senators.  The Session will be a mix of in person and virtual meetings, but we will have little to no access to the Members for in depth conversation once the Session starts.  It will be even more important that all of us reach out before Christmas and talk about what is important to us!

Other topics:

  • Quarterly Statements from VEC for the Quarter ending 30 June have recently come out – this is one to read carefully!  Since there have not been telephonic hearings since the State of Emergency was declared, it is more difficult to know the outcome of unemployment issues.  You may find that some of the claims already paid are not legitimate.  There is an option to appeal and clearly that is worth the effort. 
  • There have been several complaints about service authorizations for day services being pended or denied because services were not being provided.  We understand that if an individual has elected to have services in the home with a different provider, the original authorization will be ended.  This may also apply to and individual who is getting a different service, eg., companion service, at the same time that the original day service would have been provided.  However, authorizations should continue for individuals who simply can not come back due to their concern for exposure, or if a provider can not reopen due to lack of willing participants.  We are trying to workout the issues with DBHDS and DMAS.
  • You should have received a reminder from Heather Norton and Ann Bevan that the QSR activity is mandatory based on two previous Medicaid Bulletins; we had not heard of providers being uncooperative, but apparently a few have been!  We have heard, however, that the reporting from HSAG on the first round has been delayed, at least for some.  Reports are due to the provider 30 days after the completion of the PQR and PCRs.  The original time frame suggests that providers will have completed and implemented their Quality Improvement Plans by the end of December so the second round (to confirm all of the improvements!) could be complete by the end of the first quarter of 2021.  Seems unlikely!

Have a very safe and happy Thanksgiving!
We have much to be thankful for and
more to look forward to in 2021.