Virginia Regulatory Town Hall
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Department of Medical Assistance Services
 
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Board of Medical Assistance Services
 
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11/22/21  4:04 pm
Commenter: Fairfax-Falls Church Community Services Board

Draft-ARTS Manual-II,IV
 

Fairfax- Falls Church Community Services Board agrees and supports all the feedback/comments to date below:

 

  1. Chapter II, Provider Participation Requirements, Page: 9 

Assure freedom of choice to individuals in seeking medical care from any institution, pharmacy, or practitioner qualified to perform the service(s) required and participating in the Medicaid Program at the time the service is performed;

 

  • Comments/feedback: Further feedback is needed with this requirement as it pertains to, if clinical input will take precedence when an individuals judgement is impaired.

 

 

  1. Chapter II, Provider Participation Requirements, Page: 23

Each therapy session must contain the dated co-signature of the supervising provider within three one business days from the date the service was rendered indicating that he or she has reviewed the note. The direct supervisor can be the licensed program supervisor/manager for the agency.

 

  • Comments/feedback: Clear and concise direction is needed regarding whether this flexibility will affect only Licensed Residents and Supervisees, or if will extend to CSACs.

 

  1. Chapter, IV, Covered Services, Page: 26

The Substance Abuse and Mental Health Services Administration (SAMHSA) describe the need for clinicians to use evidence-based screenings and assessments to appropriately and timely to identify individuals at risk for SUD and mental illnesses and be able to engage in treatment. The purpose of screenings for SUD are for individuals who do not have an established SUD diagnosis and to determine whether an individual needs further assessment. The purpose of assessments for SUD are to gather detailed information needed for defining or supporting a diagnosis and development of a treatment plan that is person-centered.

 

  • Comments/feedback: Clarity is needed within this revision regarding if a screening is required for individuals whether or not they have a SUD diagnosis and will need an assessment.

 

  1. Chapter, IV, Covered Services, Page: 30

The comprehensive ISP shall be developed and documented within 30 calendar days of the initiation of services to address needs specific to the member's unique treatment as identified in the multidimensional assessment as applicable to the ASAM Level of Care. If members are discharged from the service prior to 14 the initial 30 calendar days, the provider is still required to have the ISP documented in the member’s medical record.

 

  • Comments/feedback: Additional clarity is needed regarding this revision and what is required from the provider. Please clarify what documentation is needed when an individual is discharged from services prior to 14 calendar days.

 

  1. Chapter, IV, Covered Services, Page: 31

ASAM Level 3.5 to 3.1: The licensed CATPscredentialed addiction treatment professional including Residents in Counseling or Psychology and Supervisees in Social Work, as well as CSACs and CSAC-supervisees in collaboration with interdisciplinary team. The licensed CATPscredentialed addiction treatment professional must sign off on the ISP developed by a CSAC or CSAC-supervisee. CSACs and CSAC-supervisees may perform ISP reviews in Levels 3.1, 3.3, and 3.5 if the CATP signs and dates the ISP within one business day.

 

  • Comments/feedback: Consider parody with other sections of the ARTS manual for this requirement, and allow Residents and Supervisees three business as opposed to one business day for signatures.

 

  1. Chapter, IV, Covered Services, Page: 34

During months where a quarterly review is conducted, no additional documentation is necessary to meet 30 day ISP review requirements.

 

  • Comments/feedback: Clear guidance is needed regarding documentation requirements during months where a quarterly review is due.

 

  1. Chapter, IV, Covered Services, Pages: 39-40

Retroactive requests for authorizations will not be approved with the exception of retroactive Medicaid eligibility for the individual. When retroactive eligibility is obtained, the request for authorization must be submitted to the service authorization contractor no later than thirty (30) days from the date that the individual’s Medicaid was activated; if the request is submitted later than thirty (30) days from the date of activation, the request will be authorized beginning on the date it was received.

 

  • Comments/feedback: Consider not limiting the retroactive request to within 30 days. We recommend the timeframe be extended to at least within 90 days to allow flexibilities to meet this requirement.

 

 

 

CommentID: 116731