Policies

Draft policies are online. They will be finalized and posted on the Provider Guidance and Policy webpage by January 2, 2025.

Modified policies include:

• Care Coordination Policy
  • Look for expanded guidance on Quarterly Reviews along with a new How-To document for Individual Plan Agendas.
  • Care coordinators must verify any conflict-of-interest exemptions continue to apply at quarterly reviews.
• All Supportive Service Policies
  • Use of Therap Case Notes is required beginning January 6. This requirement is noted in policy Documentation sections.
  • Non-covered service sections modified to clarify text and electronic messages as well as member transportation (outside of non-medical transportation) are non-billable services.

Policy changes are noted by new language included in arrows as shown below:

«new language»

New Guidance

• Provider Education Session slides are online on the Provider Trainings & Information Sessions webpage. The 12/30/24 session recording will be posted soon.
• Individual Plan Agenda for Quarterly Reviews How-To is posted under Care Coordination Policy and Forms.
• Plan of Care Change Form Request How-To for plan updates including changing provider names and quarterly/interim reviews.

These sessions are for agency staff who send and accept service referrals.

The training will cover how care coordination agencies can generate Therap referrals to supportive service provider agencies. Therap referrals will be required at the end of January/beginning of February 2025. Exact date to be announced. Therap referrals will replace the Service Provider Request form.

*All sessions will have the same information. You only need to attend one training.

• January 8, 2025, at 1 p.m. CT
• January 15, 2025, at 1 p.m. CT
• January 22, 2025, at 1 p.m. CT

Plan of Care Template

The 1.2025 Plan of Care template must be used for all new initial or annual plans beginning January 6, 2025. The old template will then be discontinued.

Plan changes and Quarterly/Interim Reviews will be done using Change Forms in Therap. These can only be done with approved plans.

You will be able to submit plan changes in the most recent template until you need to do a member's annual review or choose to update their plan to the new template.

This Housing Supports survey is for current and interested housing support providers. Tell us about your housing support experiences and what you'd like to see happen with housing support moving forward.

Please complete the survey by January 10.

Non-Medical Transportation (NMT)

Reminder: NMT is to assist members with gaining access to 1915(i) and other community services, activities, and resources as specified in the member's plan of care and when no other sources of transportation are available to the member at no cost. This does not include transportation to medical appointments, which is covered under non-emergency medical transportation.

This means that care coordinators and supportive service providers like peer and housing support specialists cannot transport members and bill for that time. Peer and housing support specialists (or other supportive service providers) can however, be cross-trained and enrolled to also provide NMT and bill for their transportation time as NMT and service time as either peer or housing support. Care coordinators cannot bill for transporting members under any circumstance. 

NMT documentation should reflect that other sources of transportation are being explored. If transportation is a barrier for the member, we expect to see a transportation goal and steps towards getting the member reliable and ongoing transportation access aside from 1915(i) NMT.

Discharging Members

Ensure your service documentation is complete prior to sending us discharge notification or discharging the member from your caseload. 

Simply submit your POC in Therap and we will either APPROVE the plan as submitted or RETURN the plan for changes.

Returned plans will be accompanied by a Secure Communication (SComm) in Therap about the needed changes. You will then submit the plan again when changes are made.

We will work submitted plans in chronological order by the date of submission. Remember, you can back date billing to the date of submission in Therap.

We will be removing the Plan of Care Approval Requests for New and Amended Plans blue button from the Provider Guidance and Policies webpage in the near future.