AAU Provider Update: 042210 Changes in OPX Accounts

ADvantage Administration Unit Provider Update: Changes in Optional Expense Fund Accounts (OPX) that will have a direct impact on Service Plan Development

Apr. 22, 2010

In response to a change in the guidelines for the purchase of goods and services in Consumer Directed programs issued by the Centers for Medicaid and Medicare services (CMS), the method for managing employer related expense accounts, also known as optional expense fund accounts, (OPX ) will change in the CD-PASS service option.

OKDHS Administration has developed a new process that will provide for increased preplanning and decision making on the part of the member as to how their CD-PASS optional expense funds will be allocated each service plan year. Once transitioned to the new process, members will no longer have an Optional Expense account (OPX maintained separately from their service plan funds by the Payroll Agent, Public Partnerships. Instead, the funds designated for optional expenses will be an additional line on the service plan (Case Management form AdV6e) and considered as part of the total service plan budget. Reimbursement of funds will be requested by the member using the current reimbursement request forms. Unexpended funds will not be carried forward to the next plan year.

Consumer Directed Agents will be responsible for modifying the service plan and adding the T2025 code during the transition month specified. The effective date of the change must occur during the transition month.

For annual reassessments that are due during the months of July - Dec. 31, 2010, the Consumer Directed Agent will add the new code to the service plan when meeting with the member at the time of the annual reassessment.

For service plans that have already been reassessed between the months of January 2010 through May 2010, it is recommended that the Consumer Directed Agent plan for the change during the monthly monitoring visit with the member.

Please reference the chart below to identify the transition month for each service plan.

To prepare for the transition, the CD-PASS team at the ADvantage Administration Unit will conduct training sessions for all CD-PASS Consumer Directed Agents. The new OPX process, tools, and related CDA responsibilities will be thoroughly described. The dates for June training sessions will be announced via an email communication prior to the training.

If you have any questions or concerns regarding the information provided above, please feel free to contact Provider Questions.