AAU Provider Update: Reassessment Report

In an effort to provide the best possible information, the ADvantage Administration Unit (AAU) has revised the Reassessment Report to be more user-friendly.  The Reassessment Report is used to determine the timeliness of ADvantage Service Plan submissions.  The newly revised monthly report reflects: 

• The actual number of plans expected;
• The number of Service Plans AAU received and,
• of those plans received, how many were received on time
• The number of plans expected that have not been submitted yet  (New to this report)

This report will be provided to each Case Management Agency on the 15th of each month, or the first business day following the 15th day, should the 15th fall on a non-business day.  The report will list summary information for all Case Management agencies and will identify your specific Agency by the WMIS Identification Number.  If you do not know your WMIS ID, please contact the AAU.  If you would like to receive detailed data specific to your particular agency, please contact AAU for that information.

ANNUAL REASSESSMENT SERVICE PLAN STANDARD:

AAU must receive annual Reassessment Service Plans for authorization no earlier than 60 calendar days and at least 30 calendar days before the current plan end date.

REFERENCE: Oklahoma Administrative Code - 317:35-17-14. Case Management Services

 “The case manager completes and submits to the AAU the annual reassessment service plan documents no sooner than 60 days before the existing service plan end date but sufficiently in advance of the end date to be received by the AAU at least 30 calendar days before the end date of the existing service plan.”

REASSESSMENT REPORT - PERFORMANCE EXPECTATIONS

The newly revised Reassessment Report will be provided to agencies for the next several months as an informative quality improvement tool.  Per new expectations from the Centers for Medicare and Medicaid services (CMS) there are multiple performance measures built into the ADvantage waiver renewal application.  One of the performance measures reads as follows:

“Number and percent of member Service Plans received 30 days prior to the end date of the existing service plan.”  

CMS expects states to meet all waiver related performance measures at 100%.  Anything less than 100% requires descriptive and sustainable remediation activity, reportable to CMS. At this point in time, there are several agencies that are consistently not meeting the performance measure on a monthly basis.  OKDHS is providing the Reassessment report with the expectation that agencies will use the data to immediately improve submission timelines as applicable.  The report will also be used by the AAU to monitor Case Management Agency compliance with the standards for the submission of Annual Reassessment Service Plans Agencies that fail to demonstrate improvement over the next several will be at risk for punitive action.

PLEASE NOTE:  Sanctions previously vetted are on hold at this time to allow agencies time to utilize the newly revised report and make adjustments to their business practices as needed.  (See AAU Update – Submission of Annual Reassessment Service Plans – Feb. 8, 2011)

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