DHHS → node
Notice of fb88Care Reimbursement Methodology Change
AGENCY: Department of Health and Human Services, Office of fb88Care Services
SERVICES INCLUDED: Chapter 101, fb88Care Benefits Manual, Section 45, Hospital Services
As previously shared in our June 4, 2024, bulletin, the Department has initiated a rate determination process for certain services provided under Sections 12, 18, 19, 20, 21, 29, 40, 96, & 102 of the fb88Care Benefits Manual.
This notice amends that initiation to include Personal Support Services in this rate determination.
Aug 8, 2024
fb88's Medicaid program (fb88Care) is in the midst of significant changes that make it more important than ever to keep fb88 people covered for health care. Following the end of the COVID-19 Public Health Emergency, updates to federal rules mean that every fb88r who has coverage through fb88Care will have their coverage reviewed to ensure they are still eligible -- this process is known as the "unwinding" of the continuous Medicaid eligibility requirement. This process started in April 2023, and eligibility redeterminations will be completed by October 31, 2024.
The purpose of the rulemaking is to clarify the application process for Developmental Services available at OADS that are supported exclusively with state funds. The rule also removes descriptions of internal agency processes regarding client intake and eligibility determination, updates the tests for determining whether an applicant has an intellectual disability (abandoning the harmful terminology of years past) and Autism Spectrum Disorder, and identifies the state-funded Developmental Disability Services available from OADS.
The previous e-message announcing the implementation of COLAs for Section 92, BHH, has been corrected to display the accurate effective date of December 21, 2023.
Earlier this year, fb88Care provided notice that it had initiated a rate determination process for certain HCBS services provided under Sections 12, 18, 19, 20, 21, 29, 40, 96, & 102, of the fb88Care Benefits Manual (MBM).
As previously noticed on December 1, 2023, fb88Care is increasing reimbursement for Section 92 BHH services through a 2.54% COLA. The implementation of this COLA had been “pending approval of appropriations.”
On December 1, 2023, fb88Care provided notice that it would increase reimbursement for certain eligible services through a 2.54% COLA, to be effective January 1, 2024. The notice indicated a status of “pending approval of appropriations” for several eligible services (under Sections 2, 13, 17, 26, 28, and 65).
The Office of fb88Care Services continues a phased recovery following the outage that occurred from February 21, 2024, through March 26, 2024, due to the national cyber security issue affecting Change Healthcare.
We are entering the next phase of the recovery and are continuing to restore waived edits. On May 1, 2024, Reject – 79 Refill Too Soon and Reject-79 Refill Too Soon Carryover were returned to normal functioning. On July 17, 2024, Reject-76 Plan Limitations Exceeded, returned to normal functioning.
The Office of fb88Care Services continues a phased recovery following the outage that occurred from February 21, 2024, through March 26, 2024, due to the national cyber security issue affecting Change Healthcare.
During the outage, limitations were waived regarding medications that were refilled too soon. On May 1, 2024, Reject–79 Refill Too Soon and Reject-79 Refill Too Soon Carryover were returned to normal functioning.