Provider Call Follow-up from 10 April
April 10, 2020Just as the call was ending we received a request from DMAS to distribute the following:
- On March 16, 2020, the Centers for Medicare and Medicaid Services (CMS) provided guidance to the Department of Medical Assistance Services (DMAS) that no Medicaid individuals are to experience a closure in their case due to the current state of emergency due to COVID-19. In addition, DMAS and the Virginia Department of Social Services implemented system changes to prevent automatic disenrollment for certain groups of Medicaid-eligible individuals due to life events, such as attaining a maximum age for certain covered groups or having reached the end of the two month post-partum period for pregnant women. Unfortunately, due to the timing of these events, some Medicaid individuals experienced disenrollment from their existing enrollment, either reducing or ending their Medicaid benefits starting April 1, 2020.
- DMAS is currently working to reinstate all of these enrollments that were closed effective March 31, 2020. A mass re-enrollment process will occur prior to the normal cut-off date, April 16, 2020, for these individuals. This re-enrollment will retroactively reinstate coverage starting April 1, 2020 and going forward and will re-enroll these individuals in their previous managed care health plan.
- DMAS is committed to ensuring that providers rendering services for the impacted members will be reimbursed for the members with an existing, open service authorization. Please continue to provide the same level of service that you previously had been for these individuals. Information regarding these closures and re-enrollments is being sent in a letter to the affected individuals (see attached). If one of your clients has been affected by a closure during this state of emergency, you may view the provider portal periodically to check that the individual is reinstated.
- It is still possible for manual closures to occur, although these numbers should be small. DMAS teams will be monitoring any closures each week and will re-enroll individuals who have been erroneously removed from coverage through the end of the emergency. DMAS will also continue to communicate with local DSS agencies to give clear direction throughout the emergency. If you or one of your clients receives notification of an individual’s eligibility being terminated during this state of emergency, please have the affected individual contact his or her local department of social services. Please be aware that once this public health emergency has ended, individuals may experience a change in their Medicaid coverage based on program requirements.
- This protocol was developed by VNPP to try to provide a consolidated document for any provider who is suddenly confronted with a presumptive or confirmed diagnose in a residential setting
- It is neither an exhaustive description of what you should be doing now, nor will it cover every detail. Examples of the latter are:
- decisions you will need to make about how an individual may be separated from others in the home in a way that they will comply with minimal trauma, or
- how the bathrooms will be “assigned” and cleaned after use.
We hope it is helpful, and truly hope that you are not confronted with the situation. We believe, however, that it is “When not If” and as we begin to develop some experience, we will be able to share some tips and good practice. We will work with DBHDS as they also develop new materials in the next several weeks.
Member Call- April 17
Fri, Apr 17, 2020 9:00 AM – 10:00 AM (EDT)
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