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Overview of Upcoming LTC Online Portal Enhancements for HCS and TxHmL Waiver Programs

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On December 12, 2022, the Texas Medicaid & Healthcare Partnership (TMHP) will implement several enhancements to the TMHP Long-Term Care Online Portal (LTCOP). After the enhancements are implemented, existing information and training materials will be updated.

The following is an overview of the enhancements that are scheduled to be implemented on December 12, 2022:

Individual Plan of Care (IPC) Forms

  • Submission of a renewal or transfer at renewal will be limited to no earlier than 60 days from the end of the most recent IPC form.

    This will prevent IPC form rejections and processing delays due to IPC forms being submitted too early.
  • Submission of service units with less than one (1) unit will not be allowed.

    This will reduce the need to manually override authorized service units of less than one (1) and provide faster access to billing.

    Note: Providers and financial management services agencies (FMSAs) can continue to bill for units less than one (1). This enhancement only prevents submission of the IPC form with units less than one (1).
  • Service codes 16M and 16MV will be added for minor home modifications (MHMs) maintenance.

    This will allow individuals to use the $300 MHM maintenance and repair budget within the IPC year as needed, without the need to first use the lifetime limit of $7,500. This will be effective when the Home and Community-based Services (HCBS) settings rule becomes active and applies to future claims only. The Long-Term Care (LTC) Bill Code Crosswalk will also be updated.
  • Program provider and FMSA information will autopopulate based on the vendor and contract numbers entered on the IPC enrollment forms. This is in addition to the existing data autopopulation function of other IPC types.

    This will reduce data entry administrative burden and eliminate user error based on entry of the correct vendor or contract information.

Termination Forms

  • The status of a person’s preenrollment form will automatically change to “Terminated” after the individual’s termination form for the same program is processed/complete.

    Providers and local intellectual and developmental disability authorities (LIDDAs) will have the ability to obtain real-time individual termination information in the Home and Community-based Services (HCS) and Texas Home Living (TxHmL) programs through the Individual History and Individual Search buttons located on the LTCOP dashboard.
  • The signature checkbox (field 46) will be optional.

    This will reduce form delays by allowing accurate reflections of cases where a signature is not obtainable.

Preenrollment Forms

  • When a person’s initial or enrollment IPC is submitted by a LIDDA that is different from the LIDDA that submitted the person’s preenrollment form, the LIDDA information on the existing preenrollment form will automatically update to match the LIDDA on the initial or enrollment IPC form.

    This will eliminate confusion about the individual’s designated LIDDA.
  • The ability of a LIDDA user to inactivate a pre-enrollment form will be removed. Only the Texas Health and Human Services Commission (HHSC) Local Procedure Development and Support (LPDS) users will be able to inactivate a preenrollment form. LIDDAs can contact the assigned slot monitor to request inactivation of a preenrollment form, if needed.

    This will decrease the potential for preenrollment and enrollment forms to get out of sync and ensure that the form is not being inactivated unnecessarily.

Individual Movement (IMT) Local Authority (LA) Reassignment Forms

  • The new LA name will autopopulate based on the vendor and contract numbers entered on the form.

    This will reduce data entry administrative burden and eliminate user error based on entry of the correct vendor or contract information.
  • Form submission will be allowed for an effective date 15 days in the future.

    This will enable LIDDAs to proactively submit the form in anticipation of an upcoming change to the individual’s information and associated LIDDA. It also allows the LA reassignment status to display as “Processed/Complete” prior to entering the transfer.
  • A new checkbox asking, “Is provider also changing?” will be added.

    This will allow LIDDAs to indicate whether the LA reassignment coincides with a transfer. In this case, the new location for the individual will be input on the IPC Transfer form instead of the LA Reassignment form.

    This will provide faster access to billing by improving the transfer process when there is a LIDDA reassignment.

Individual Movement (IMT) Suspension and 3615 Forms

New suspension reasons will be available to align with new program rules effective fall 2022.

This will allow providers to accurately reflect reasons that an individual is on suspension.

Provider Location Update (PLU) Forms

  • Providers will have the ability to correct or inactivate a PLU form when an error is identified in the submitted information.

    This will reduce administrative burden and allow providers to take the appropriate action.
  • HHSC staff will have additional permissions to assist providers with submitting PLU forms.

    This will reduce administrative burden and extend HHSC staff’s support efforts for providers.

Other System and Form Enhancements

The Inactivate and Correct this Form buttons on the 8578 Intellectual Disability/Related Condition (ID/RC) Purpose Code (PC) 2 and Initial Enrollment IPC forms will be available only to HHSC staff.

This will decrease the potential for preenrollment and enrollment forms to get out of sync, as well as decreasing unnecessary form inactivations.

Account Preparation and Additional Resources

To prepare for these changes, HCS and TxHmL providers and LIDDAs that do not have an LTCOP account need to create an administrator or user account. Providers and LIDDAs can find instructions for creating an account in the TMHP Account Setup for HCS and TxHmL Waiver Programs Quick Reference Guide (QRG).

Additionally, providers and LIDDAs are encouraged to visit the TMHP 1915(c) Waiver Programs web page for recent news, reference materials, education, and bulletins.

For more information, contact the TMHP LTC Help Desk at 800-626-4117 (select option 1 and then option 7).