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Virginia Regulatory Town Hall
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Department of Medical Assistance Services
Board
Board of Medical Assistance Services
chapter
Waivered Services [12 VAC 30 ‑ 120]
Action Three Waivers (ID, DD, DS) Redesign
Stage Final
Comment Period Ends 3/31/2021
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3/24/21  1:17 pm
Commenter: Ruth Ewers

Therapeutic consultation (Behavior)
 

on C 5b. Initital requests can only be authorized for 180 days: 

There are times when it takes up to a month for ISARs to be approved. This can be even longer if the ISAR is pended (we can't start a service until final approval, so being able to bill retroactively does not help). In addition, if the staff or family has not been fully cooperative and we do not get data forms or they miss appointments, this causes another delay. Please keep authorizations at one year (or the duration of the ISP year).

On C. 5c, plans will be submitted with baseline data and quarterly data: There are many times we do not receive any data and other times we receive only partial data. At times, progress is anecdotal or evidenced by lack of emergency or crisis. For example, we may not received data but the person receiving the service has not been referred to emergency services or REACH centers. Please consider changing this to data or reports by staff and family. 

CommentID: 97416