Medicaid Services Update

To:  ADvantage Case Managers

Subject: Update on Issues with Identified Needs Sub-Tab

Date:  August 26, 2021

An issue with adding “Anticipated Outcomes” and “Actions Steps” on the Identified Needs Sub-Tab was identified on 8/23/2021. The Harmony vendor has identified the cause of the issue and is expecting to deploy the correction to production on Sunday (8/29/2021) during the normal maintenance window.

During the period in which Case Managers (CMs) are unable to enter “Anticipated Outcomes” and “Action Steps”, please proceed as follows:

• Priority Plans
  • CM should label Identified Needs as Active, Complete, Deferred, Duplicate, or Pending, as appropriate, and submit the Plan to the Case Manager Supervisor (CMS) for Supervisor Review.
  • CMS should review and submit to MSU as normal.
  • MSU will review and, if all other criteria are met, will give a one-month authorization to avoid service delays.
  • After the systems issue has been corrected, the CM will need to add the appropriate “Anticipated Outcomes” and “Action Steps” and follow the process to resubmit the plan for full authorization.
  • Plans already submitted to MSU without the “Anticipated Outcomes” and “Actions Steps” and pending MSU review will be given the short-term authorization as appropriate. 
• Plans that are not a priority, such as annual reviews, should be held until Monday when the Identified Needs Sub-Tab issue is corrected and can be completed in full prior to submission to MSU.

Please submit any questions regarding this information through the Harmony PQ chapter.

Thank you for your service to our waiver Members.

COMMUNITY LIVING, AGING AND PROTECTIVE SERVICES (CAP) MEDICAID SERVICES UNIT (MSU)
ADvantage Administration | State Plan Care Unit | Medical Eligibility Services
Office: 918-933-4900 | CareLine: 800-435-4711