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Important Messages
 

Attention Connecticut Home Care (CHC), Personal Care Assistant (PCA), Acquired Brain Injury (ABI), Autism and Mental Health (MH) Waiver Service Providers: Alternate Electronic Visit Verification (EVV) - Personal Care Services (PCS) Town Hall Session #2 and #3 Dates & Registration Links (Posted 3/28/2024)

Attention Home Health Providers: Important Electronic Visit Verification (EVV) Reminders - as of March 22, 2024

Attention Connecticut Home Care (CHC), Personal Care Assistant (PCA), Acquired Brain Injury (ABI), Autism Waiver Service Providers and Support and Planning Coach (S&PC) Providers: New Fiscal Intermediary (FI) for Connecticut, GT Independence to support Waiver and S&PC Credentialing Process (Posted 3/22/24)

Hospital Monthly Important Message (Posted 3/18/24)

Electronic Data InterChange (EDI) Transaction and Trading Partner Updates (Posted 3/7/24)

Attention Dental Providers: UPDATED Service Interruption (Posted 2/29/24)

Attention Pharmacy Providers: Options for Pharmacies Affected by Optum Change Healthcare (CHC) Network Service Interruption (Posted 2/23/24)

Attention Providers and Trading Partners: Optum Change Healthcare (CHC) network service interruption (Posted 2/22/24)

ATTENTION Obstetrics & Gynecology and Family Practice Physicians and APRNs, Women's Health APRNs and Certified Nurse Midwives: Register for the HUSKY Maternity Bundle Provider Forum (Posted 2/12/24)

Attention Home Health Providers: Electronic Visit Verification (EVV) Updates as of February 9, 2024

Attention All Board-Certified Behavioral Analysts (BCBAs) and Autism Specialty Groups: BCBA Licensure Requirement for Enrollment in Connecticut Medical Assistance Program (Posted 1/31/24)

Attention Outpatient Hospitals: CMAP Addendum B Updated (January 1, 2024) (Posted 1/23/24)

Attention All Providers: 2023 1099s Available on CMAP Web Site (Posted 1/19/24)

Attention Home Health Providers: Home Health Authorizations: Upcoming Change (Posted 1/11/24)

Attention All Providers: Revised CT Medical Assistance Program (CMAP) Telehealth Table - Updated the end date to 2024 (Posted 12/27/23)

Attention All Providers: CMAP Telehealth Services (Posted 11/27/23)

Attention Acquired Brain Injury, Connecticut Home Care Program, and Personal Care Services/Assistant (PCA) Providers: Prior Authorization Issue (Posted 11/22/23)

Attention Behavorial Health Clinics: UPDATE Performing Providers Required for Behavioral Health Clinic Claim Submission (Posting 9/22/23)

HUSKY Health Primary Care Payment Program Extension Notification


Click here for Archived Messages


 
RA Banner Announcements
 
Banner Effective DateProvidersBanner Page Announcement
03/22/2024-03/29/2024Attention Select ProvidersAttention Select Providers. PCMH REPROCESS: Providers enrolled in the Person-Centered Medical Home Initiative (PCMH) were enrolled with retroactive effective dates or were approved for changes in PCMH level or site address with retroactive effective dates. Claims which processed prior to the completion of the provider's PCMH enrollment or level/site address change were not paid with the PCMH differential payment rate and have now been reprocessed to include that amount. For any providers with retroactive site terminations, claims which processed with the PCMH differential payment rate have now been reprocessed without that amount. The impacted claims have been identified and reprocessed and will appear on your March 27, 2024 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
03/22/2024-03/29/2024Attention Select ProvidersAttention Select Providers. REPROCESSED THIS CYCLE: Primary Care Providers enrolled in the Person-Centered Medical Home Initiative (PCMH) were enrolled with retroactive effective dates or end dated from the PCMH program. Claims which processed prior to the completion of the provider's PCMH enrollment were not paid with the PCMH differential payment rate and have now been reprocessed to include that amount. For those providers retroactively end dated, claims were paid with the PCMH differential payment rate that have now been reprocessed without that amount. The impacted claims have been identified and reprocessed and will appear on your March 27, 2024 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 55.
03/22/2024-03/29/2024Attention Select ProvidersAttention Select Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed Professional and Professional Crossover claims that incorrectly paid at the Default (DEF) rate instead of the Facility (FTD) rate for procedure code 99152, when billed with a facility place of service of 19,21,22,23,24,25,31 or 32. The reprocessed claims will appear on the March 27, 2024 Remittance Advice (RA) with an ICN beginning with region code 52.
03/22/2024-03/29/2024Attention Home Health ProvidersAttention Home Health Providers. All home health providers are reminded that they should now be utilizing Electronic Visit Verification (EVV) to capture Home Health Care Services (HHCS) visit data in accordance with the federal mandate in the 21st Century Cures Act. Effective for dates of service March 22, 2024, through March 31, 2024, providers will see an explanation of benefit (EOB) code post to claims but still pay when a confirmed visit cannot be found or when units are exceeded. Effective for dates of service April 1, 2024, and forward, providers will receive claim denials when a confirmed visit cannot be found or when units are exceeded. Please note that as of April 1, 2024, the following medication administration procedure codes will not be subject to EVV claim editing: T1502, T1503, and H0033. Providers must continue to use EVV to capture visit data for these services. Providers utilizing Sandata Agency Management will be issued step-by-step instructions on how to enter visits for medication administration services that are less than 8 minutes. Claim edit enforcement dates for medication administration procedure codes will be communicated in a future Important Message.
03/22/2024-03/29/2024Attention Connecticut Home Care (CHC), Personal Care Assistant (PCA), Acquired Brain Injury (ABI), Autism and Mental Health (MH) Waiver Service ProvidersAttention Connecticut Home Care (CHC), Personal Care Assistant (PCA), Acquired Brain Injury (ABI), Autism and Mental Health (MH) Waiver Service Providers. REMINDER OF OPTIONAL TRANSITION TO OPEN VENDOR ELECTRONIC VISIT VERIFICATION (EVV) MODEL. In 2016, Section 12006 of the 21st Century Cures Act established a requirement for all states to use an Electronic Visit Verification (EVV) system for Medicaid-funded Personal Care Services (PCS). Currently, the Department of Social Services (DSS) and Department of Mental Health and Addiction Services (DMHAS) utilize a State Mandated External Vendor model for the collection of PCS visit data. All PCS providers are required to submit visit data to the system designed by the State's external EVV vendor (i.e., Sandata Technologies). DSS and DMHAS will be transitioning from a State Mandated External Vendor model to an Open Vendor EVV model with an aggregator solution for PCS. The Open Vendor EVV model will allow providers the opportunity to use either the State's existing external EVV vendor system (i.e., Sandata Agency Management) or their own third-party ("Alternate EVV") system to capture visit data. Changes to accept all PCS visit data from either the State's existing EVV system or an Alternate EVV system are targeted for implementation in May 2024. Additional information, including vendor specifications and upcoming Town Halls, can be found on the www.ctdssmap.com Web site by selecting Information > Publications and performing a search on PB24-22 Open Vendor Electronic Visit Verification (EVV) Model Implementation for Personal Care Services (PCS) - Technical Specification and Town Hall Registration.
03/22/2024-03/29/2024Attention Home Health, Connecticut Home Care (CHC), Personal Care Assistant (PCA), Acquired Brain Injury (ABI), Autism and Mental Health (MH) Waiver Service ProvidersAttention Home Health, Connecticut Home Care (CHC), Personal Care Assistant (PCA), Acquired Brain Injury (ABI), Autism and Mental Health (MH) Waiver Service Providers. Providers are reminded that Sandata released a new SMC mobile application with enhanced features. All providers must be using the "NEW SMC 2.0" version by June 15, 2024, as the previous application will no longer be supported after June 30, 2024. Please use the following Sandata on Demand (SoD) link to download the SMC 2.0 application as well as review articles (e.g., Introduction, Language Support, Offline Mode) and screenshots of the different application screens (e.g., Visits Screen, Clients Screen, Settings Screen): https://sandata.zendesk.com/hc/en-us/sections/18037326015635- Sandata-Mobile-Connect-SMC-Version-2. Providers are also encouraged to review the SMC 2.0 application video library at the following SoD link: https://sandata.zendesk.com/hc/en-us/articles/21560498569491-- Sandata-Mobile-Connect-2-0-Video-Library.
03/22/2024-03/29/2024Attention Connecticut Home Care (CHC), Personal Care Assistant (PCA), Acquired Brain Injury (ABI), Autism Waiver Service and Support and Planning Coach ProvidersAttention Connecticut Home Care (CHC), Personal Care Assistant (PCA), Acquired Brain Injury (ABI), Autism Waiver Service and Support and Planning Coach Providers. Credentialing Update - New Fiscal Intermediary (FI) GT Independence. Providers working on credentialing through Allied Community Resources should continue to do so until March 24, 2024. Autism Waiver Service providers previously credentialed by the Department of Social Services (DSS) Community Options unit, will transition to GT Independence when renewing their credentials prior to their next reenrollment period. More information on credentialing, including an updated credentialing process will be coming soon. The current credentialing process will continue, until more information is made available.
03/22/2024-03/29/2024Attention Performing Providers Required for Behavioral Health Clinic ClaimsAttention Performing Providers Required for Behavioral Health Clinic Claims. DSS will require all claims to be submitted with an enrolled performing provider's National Provider Identifier (NPI). Currently, claims are not denied for the omission of the performing provider's NPI on Behavioral Health Clinic claims. Please refer to Provider Bulletin 2023-44 issued on June 5, 2023 for full policy. DSS has extended the time to allow providers to enroll performing providers for a full year providing sufficient time for your organization to comply. Claims will begin to deny for claims with dates of service 6/1/2024 forward. You are receiving this banner message as your organization still needs to enroll performing providers. Your ID indicates claim activity in 2024. To avoid any service interruption please complete requirement.
03/22/2024-03/29/2024Attention All ProvidersAttention All Providers. PROVIDER FILE MAINTENANCE: In order to maintain the accuracy and completeness of the Connecticut Medical Assistance Program (CMAP) network, we are requesting all providers update their provider file on a regular basis. The information that you provide is presented in the on-line provider directory at www.ct.gov/husky. Thousands of members statewide rely on the accuracy of this source of information to find a suitable health care provider. Inaccurate addresses, phone numbers, and names may affect a member's ability to contact you. To update your provider profile, the main account administrator can log into their secure Web account from the www.ctdssmap.comWeb site and click on the "Demographic Maintenance" tab. Once on the Demographic Maintenance page, the provider can select from options listed as links below the Demographic Maintenance header panel. For instance, you can update your address* if you happen to move to a new location; all you have to do is click on the "Location Name Address" link, select the address to be updated, click on the "Maintain Address" button to type in the new address and then save your changes. You can also add or remove performing providers to your group practice as applicable by clicking on "Maintain Organization Members". For detailed instructions, please refer to Section 10.18 "Provider Demographic Maintenance" in Chapter 10 of the Provider Manual. The chapter is available from the Web site www.ctdssmap.comby clicking on "Publications" under Information, scrolling down to Provider Manuals and then clicking on "Web Portal/AVRS". Providers may contact the Provider Assistance Center at 1-800-842-8440 between the hours of 8:00 AM to 5:00 PM Monday through Friday if further assistance is needed in updating the information from their secure Web portal account. *There are special instructions for PCMH providers and licensed facilities such as hospitals, pharmacies, and clinic providers for updating their service location or alternate service location addresses. Please refer to the warning messages on the Web pages, as well as Chapter 10 for additional information.
03/22/2024-03/29/2024Attention Select ProvidersAttention Select Providers. Place Of Service 55 Requirement: Based on reviewing your most current remittance advice, your organization still needs to make a claims billing changes to utilize place of service (POS) 55 before 4/1/2024. Claims with date of service on or after April 1, 2024 that are billed without POS 55 will deny with Explanation of Benefit (EOB) code 4821 "Facility Type is Restricted for Procedure Under Provider Contract". Please see bulletin PB24-09 Place of Service (POS) Requirements for Substance Use Disorder (SUD) Treatment for further details. NOTE: POS can also be referred to as facility type code (FTC).
03/22/2024-03/29/2024Attention Primary Care ProvidersAttention Primary Care Providers. REPROCESSED THIS CYCLE: Gainwell Technologies has identified and reprocessed claims for providers who were retroactively approved for the HUSKY Health Primary Care Increased Payments policy. The reprocessed claims will appear on your March 27, 2024 Remittance Advice (RA) with an Internal Control Number (ICN) beginning with region code 27 or 52.
03/22/2024-03/29/2024Attention All ProvidersAttention All Providers. HOLIDAY CLOSURE: Please be advised, the Department of Social Services (DSS) and Gainwell Technologies will be closed on Friday, March 29, 2024 in observance of the Good Friday holiday. Both the DSS and Gainwell Technologies offices will re-open on Monday, April 1, 2024.


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