This is in referrence to the released Medicaid Memo.  The issues that I have when requesting authorization for private duty nursing is that I have both RNs and LPNs working in the home.  Other EPSDT authorizations grant auth for a specific number of hours to be used by the RN or LPN.  This way, if a nurse can cover a shift or if the parent is late and a nurse stays past her scheduled hours, we are able to bill for these services without disturbing the rest of the schedule.  With the nursing shortage in Virginia, we need this flexibility in finding coverage.  Also, if we find a nurse to add to the case, they often are not able to wait while we obtain the additional hours and they end up finding another position with another company in the meantime.  

Our nurses are also now asked to complete a Part V.  There has been very little direction on how to complete this form and they are basically reiterating what is submitted in the year long plan of care.   Why is the plan of care not suffiicient?  Thank you.