Virginia Regulatory Town Hall
Department of Medical Assistance Services
Board of Medical Assistance Services
Previous Comment     Next Comment     Back to List of Comments
8/15/23  11:48 am
Commenter: Lisa McCarthy, Brain Injury Services

Assessment vs Medical Necessity MPAI Clarification

The draft states in two different places:


"Upon receipt of a referral, and prior to the delivery of BIS case management services, the case manager must make an evaluation visit to where the individual resides to conduct an assessment for service planning and begin the MPAI-4 assessment of severity of the brain injury and the person-centered planning process."


Medical Necessity Criteria

"The MPAI-4 may be completed by individuals with BI, their significant other(s), medical or rehabilitation professionals, and other designated observers who know the individual well. Comparisons among independent ratings are critical for effective rehabilitation planning, and for revealing more subtle problem areas. Scoring and interpretation of the MPAI-4 require professional training and experience"


Can you clarify exactly who completes the MPAI for a client?  From my understanding, MPAI should be completed by trained professionals so I find the statement that it can be “completed by individual with BI, their significant other” to be confusing and possibly misleading.  What does a service provider do if the assessment the complete is significantly different that one a family member submits?  I support the first paragraph but suggest you consider adding that the MPAI can be completed once there has been sufficient time to make such an assessment.  I find the second paragraph in the “medical necessity” section conflicting and confusing and am unclear if a MPAI submitted by a client or a family member should be accepted?


CommentID: 218707