Provider update: April 8, 2020
To: All ADvantage Adult Day Health Providers
Subject: Adult Day Health Process Changes related to COVID-19 Emergency Plan
Date: April 8, 2020
The Human Services Department has been working with our state and federal partners to initiate emergency plans to support our provider network as we go through this difficult time together. Please see below for a summary of those changes specific to your service type.
- To minimize the spread of infection, the community integration and unlimited visitor access requirements for Adult Day Health (ADH) services are waived for the period of the emergency.
- Adult day services may be delivered to Members in their homes when applicable. This may include provision of meals, personal care when included as an authorized ADH service, medication management, etc.
- Retainer payments are allowed for ADH Members who are unable to attend and receive services due to the COVID-19 pandemic.
- Payments are claimed per Member when the Member is not able to receive the service due to COVID-19, e.g., Member refuses due to being in high risk category, Member refuses due to fear of exposure by others attending ADH, etc.
- Payments are not allowed because the provider is unable to provide the service.
- Payments may not be claimed for any dates the Member is hospitalized, as this would be construed as duplicate billing.
- Retainer payments may not exceed seven (7) days of authorized services.
- When billing for retainer payments, please make a note in Harmony with Note Type of Adult Day Health and Note Sub-Type of Retainer Payments (see below).
- In the narrative of the Note, include the dates for which the retainer payments are being billed and the specific reason the Member is not able to participate in the ADH service.
As always, we appreciate the support you provide to our Members.
If you have questions on the content of this bulletin, please submit a Provider Question with an Inquiry type of COVID-19 Question / Issue.
AGING SERVICES | MEDICAID SERVICES UNIT
ADvantage Administration | State Plan Personal Care
Office: 918-933-4900 | CareLine: 800-435-4711