Rates, Rates, Rates!

October 13, 2021

Most of you now know that the rate chart linked to the Medicaid Memo referenced in Friday’s News Post for BH and ARTS rates was a) missing rates for several services and b) contained misleading information concerning a number of services which are being “repurposed” on December 1st as part of the BRAVO initiative.  Thanks to a alert member, we were able to get DMAS to pull the chart from the website by Friday evening – thanks to the several DMAS staff who stepped in quickly to to that!

We have checked on the progress for reposting the table and are now told that they hope to get it back up “by the end of the week.”  We have also reviewed the FAQs which are posted and find them to also be very confusing regarding the services which are being “repurposed” on December 1st as part of the BRAVO initiative.  We have asked DMAS staff to review for clarity!

On the bright side – if you only need to be concerned with DD Waiver services/billing, you are in luck!  As of last Friday, the increased rates are “in the system” and billing should go smoothly for services provided after July 1, 2021.  While DMAS plans to reprocess all of the previously submitted claims, providers can reprocess their own claims if they choose to do so.   Adjusting charges on a previously paid claim uses adjustment code 1030; if you do the adjustment (or an original invoice) with the higher amount and DMAS follows with reprocessing, you will end up with a very long remittance advice form, but the bottom line with be “net $0!” 

And, on the subject of rates – at this point, it appears that the DD Waiver Rebase may not be included in the Governor’s Budget; we should have the study report in the next week or so, and will add that to the information on the increased costs to support the minimum wage increases to make our case to the General Assembly in January.  More to follow as we get details.  Disappointing, but sadly not unexpected!