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HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 22

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Since May 2, 2022, Home and Community-based Services (HCS) and Texas Home Living (TxHmL) program providers, local intellectual and developmental disability authorities (LIDDAs), and financial management services agencies (FMSAs) billing on behalf of consumer-directed services (CDS) have been submitting claims and forms to the Texas Medicaid & Healthcare Partnership (TMHP). TMHP has received feedback from providers and LIDDAs indicating that additional support is required. Resolutions regarding the most frequently reported issues are presented in the table below.

Topic

Resolution

Saved Form Drafts

Long-Term Care Online Portal (LTCOP) users attempting to submit forms using saved drafts created before the July 3, 2023, LTCOP update will receive error messages stating, “ATTACHMENTS is required.” If they receive this message, providers and LIDDAs must use a new form draft to prevent submission delays.

Updated IPC IBI Guides to Clarify IPC Transfers Without Changing Provider/FMSA Contract

The 3608 HCS Individual Plan of Care (IPC) and 8582 TxHmL IPC item-by-item (IBI) guides have been updated to provide clarification on transfers with no contract change of the provider or FMSA. To avoid units splitting when completing these forms, providers and LIDDAs should review the 3608 HCS IPC and 8582 TxHmL IPC IBI guides on the TMHP Learning Management System (LMS) for updated instructions on the following items:

  • Section 2­­ Receiving Program Provider's Information
  • Section 4­­ Receiving CDSA's Information
  • Field 91 Transfer this Service

Note: To access the LMS, users must have an account. New users can register for an account or access the Learning Management System (LMS) Registration and Navigation Job Aid for Providers located on the LMS home page. Alternatively, they can send an email to TMHP Training Support for assistance with creating an LMS account or navigating the LMS.

For more information on this clarification, view the July 2023 – TMHP LTC Town Hall for HCS/TxHmL Providers and FMSAs webinar recording.

CDS Claims Billing

Data entered into the IPC for the IPC year must be verified in Medicaid Eligibility Service Authorization Verification (MESAV) before billing for CDS. Submitters should enter the dollar amount in the following IPCs and their fields for CDS services:

3608 HCS IPC:

  • 31a Consumer Directed Services Agency Authorized Units
  • 87b Authorized Units

8582 TxHmL IPC:

  • 31 Consumer Directed Services Agency Authorized Units
  • 87b Authorized Units

If a CDS service is billed using units instead of dollars, providers are at risk of not getting the correct dollar amount for their claim.

Note: CDS and Community First Choice (CFC) financial management services (service codes 63V and 63CFV) are not billed by dollar amounts; they are billed by units.

FAQ Updates

Updated HCS and TxHmL Waiver Programs Frequently Asked Questions (FAQs) documents will be available July 26, 2023. The documents will include FAQs from the recent LTC Online Portal Enhancements for HCS and TxHmL Providers and LIDDAs Webinars. It is strongly recommended that users check one of the following FAQ links for updates:

View previous postings below:

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 21

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 20

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 19

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 18

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 17

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 16

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 15

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 14

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 13

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 12

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 11

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 10

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 9

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 8

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 7

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 6

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 5

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 4

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 3

HCS and TxHmL Waiver Programs: Trending Issue Support, Volume 2

HCS and TxHmL Waiver Programs: Trending Issue Support

HCS and TxHmL Providers Must Use Bill Codes Listed in the HCS and TxHmL Bill Code Crosswalk for Claims Submission

Important Claims Submission Information for HCS and TxHmL Programs

LTC Online Portal Dashboard Accessibility Issue Resolved

IPC Forms 3608 and 8582 Issue Resolved

HCS and TxHmL FAQ Updates Available May 9, 2022, and May 23, 2022

Individual Plan of Care (IPC) Training Materials for HCS and TxHmL Waiver Programs

Now Available: HCS and TxHmL Programs Forms and Claims Submissions to TMHP

EVV Updates for the HCS and TxHmL Transition to TMHP for Claims Submission

For assistance with any further questions, contact the TMHP LTC Help Desk at 800-626-4117 (select option 1 and then option 7).