INARF
​​Home | login | contact us
  • About Us
    • About Us
    • Board of Directors
    • Staff
    • Corporate Committees
    • Professional Interest Sections
    • Awards & Recognition
  • Membership
    • Member Login
    • Membership
    • Member Benefits & Inquiries
    • Organizational Member Directory
    • Associate Member Directory
    • Member Job Postings
  • Events
    • Upcoming Events
    • INARF 2022 Pre-Conference
    • INARF 2022 Annual Conference >
      • Sponsor Opportunities
      • Exhibit Opportunities
      • Artisan Opportunities
      • Annual Awards
  • Professional Development
    • Professional Development
    • INARF DSP Series
    • INARF Leadership Academy
  • Technical Assistance
    • Technical Assistance
    • News & Information
    • Resources
  • Governmental Affairs
    • Governmental Affairs
    • INARF PAC
    • Bills Being Watched
    • Statehouse News
    • Take Action Now With VoterVoice!
  • About Us
    • About Us
    • Board of Directors
    • Staff
    • Corporate Committees
    • Professional Interest Sections
    • Awards & Recognition
  • Membership
    • Member Login
    • Membership
    • Member Benefits & Inquiries
    • Organizational Member Directory
    • Associate Member Directory
    • Member Job Postings
  • Events
    • Upcoming Events
    • INARF 2022 Pre-Conference
    • INARF 2022 Annual Conference >
      • Sponsor Opportunities
      • Exhibit Opportunities
      • Artisan Opportunities
      • Annual Awards
  • Professional Development
    • Professional Development
    • INARF DSP Series
    • INARF Leadership Academy
  • Technical Assistance
    • Technical Assistance
    • News & Information
    • Resources
  • Governmental Affairs
    • Governmental Affairs
    • INARF PAC
    • Bills Being Watched
    • Statehouse News
    • Take Action Now With VoterVoice!

INARF at Work to Enhance the Service Model for Group Home Providers 

6/28/2016

 
Recently, INARF convened a meeting between industry consultants, the Indiana Office of Medicaid Policy and Planning (OMPP) and Myers & Stauffer to discuss audit specific issues.
Specific Issues include the following:
  • Treatment of OTC drugs; skin protectants, sealants, moisturizers and ointments; dietary supplements; and other supplies procured from pharmacies. While no changes were achieved in OTC drugs, we have seen clear changes for all other categories except dietary supplements. Based upon direction received during the meeting, we have filed a request with the Medicaid Policy Team to make dietary supplements explicitly allowable. It should be noted that providers need to be separately identifying these items in their trial balances to reduce the exposure to audit adjustments. If they are grouped into one supplies account then if audit sample testing identifies non-allowable items, it could lead to extrapolation adjustments of large amounts as the percentage of non-allowable items would be applied to the entire account.
  • Mental Health Services including behavior management, psychiatric and psychological services which were clearly stated as allowable items in the all-inclusive rate.
  • Electric wheelchairs and wheelchair repairs for which there is conflicting information. Repairs are included in the LTC Per Diem Table and should be allowable. Electric wheelchairs themselves are currently not on the list but we are to present examples of dis-allowances and non-coverage for the DME billing.
  • Administration costs included in day services cost and the home office allocation that Myers & Stauffer consider a double allocation. There was not movement on this issue.
  • Cost of professional services that are considered related to patient care including program consultants (allowable), human resources/benefits consultants (allowable), board consultants (allowable depending on the issue) and investment advisory fees (not allowable).
  • Calculation of weighted medians and the exclusion of providers that have closed or undergone a change of ownership. There was agreement that closed facilities should be excluded. Relative to change of ownerships, there was no movement and OMPP has included this in an update of the reimbursement regulations that should be coming out in the next few weeks.
  • Request to change the capitalization policy amount from $500 per item to $1,000 per item consistent with the nursing homes. There was no movement but we can file a request with the Medicaid Policy team to review this issue.
In the next few weeks, OMPP should be issuing some changes to the group home reimbursement rules which in addition to some verbiage cleanup should include the following: 
  • Department Head will be defined as an individual responsible for the supervision and management of a ICF/IIF or CRF/DD department. Home office personnel responsible for the supervision and oversight of these department heads will be subject to the Owner/Related Party/Management Limit. Practically speaking depending on your structure this may or may not be a change. Rule now will clearly include vice presidents and regional supervisors as subject to the limit
  • Information for field audits must be provided 30 days prior to the audit field date. Failure to provide this information could lead to a 10% rate penalty for each facility for each month until the information is provided.
  • In the event of a change of ownership or control, require the filing the Checklist of Management Representations Concerning Change in Ownership as is current practice. Allows OMPP to assess a 10% penalty if the Checklist has not been submitted within 90 days of the transaction date.
  • For purposes of determining medians, providers whose most recently completed rate is an initial interim rate (e.g. will file a 9 month historical cost report) shall be excluded from the determination.
  • Sunsets all rate reductions effective June 30, 2016 including the .09% rate reduction currently in place. As a result, group home rates will be adjusted effective July 1, 2016 to restore the .09% rate reduction currently in place. Rates will be issued in the next few months depending on CMS approval of the state plan amendments and the status of provider rates. For example, all providers with rates usually effective on 10/1 will receive new 7/1 rates all at one time. Those providers that have 4/1 rates will receive their revised 7/1/16 rates only after their 4/1/16 rates are issued.
If you should have any questions regarding any of these issues, please do not hesitate to contact the INARF office or Sarah Chestnut.



Comments are closed.

    RSS Feed

    Archives

    May 2022
    April 2022
    March 2022
    February 2022
    January 2022
    December 2021
    November 2021
    October 2021
    September 2021
    August 2021
    July 2021
    June 2021
    May 2021
    April 2021
    March 2021
    February 2021
    January 2021
    December 2020
    November 2020
    October 2020
    September 2020
    August 2020
    July 2020
    June 2020
    May 2020
    April 2020
    March 2020
    February 2020
    January 2020
    December 2019
    November 2019
    October 2019
    September 2019
    July 2019
    June 2019
    May 2019
    April 2019
    March 2019
    February 2019
    January 2019
    December 2018
    November 2018
    October 2018
    September 2018
    August 2018
    July 2018
    June 2018
    May 2018
    April 2018
    March 2018
    February 2018
    January 2018
    December 2017
    November 2017
    October 2017
    September 2017
    August 2017
    July 2017
    June 2017
    May 2017
    April 2017
    March 2017
    February 2017
    January 2017
    December 2016
    November 2016
    October 2016
    September 2016
    August 2016
    July 2016
    June 2016
    May 2016
    April 2016
    March 2016
    February 2016
    January 2016
    December 2015
    November 2015
    October 2015
    September 2015
    August 2015
    July 2015
    June 2015
    May 2015
    April 2015
    March 2015
    February 2015
    January 2015
    December 2014
    November 2014
    October 2014
    September 2014
    August 2014
    July 2014
    June 2014
    May 2014
    April 2014
    March 2014
    February 2014
    January 2014
    December 2013
    November 2013
    October 2013
    September 2013
    August 2013
    July 2013
    June 2013
    May 2013
    April 2013
    March 2013
    February 2013
    January 2013
    January 2011
    September 2009
    December 2007

© Indiana Association of Rehabilitation Facilities, Inc. (INARF)
    615 North Alabama Street, Suite 410, Indianapolis, IN 46204
    (t) 317-634-4957 / (f) 317-634-3221 / Contact us by email
ANCOR Proud Member Small