Medicaid Services Update
To: ADvantage Case Management and Home Care Providers
Subject: Change in UCAT Eligibility Assessment Process
Date: October 20, 2021
On August 23, 2021, the Medicaid Services Unit (MSU) implemented an online application portal for Medicaid in-home services. Prior to implementation of the portal, referrals to the MSU Eligibility Services team were made through another division of the Agency. Upon go-live of the online portal, the MSU began receiving an extraordinarily high number of applications, tripling what had been received through the prior workflow process.
As announced during the Provider Meeting on Friday, 10/15/2021, in order to manage the influx of applications and ensure eligibility assessments are completed timely, MSU Eligibility Services is temporarily implementing an abbreviated assessment process. This process will facilitate expedited eligibility determinations by focusing on the areas of the Uniform Comprehensive Assessment Tool (UCAT) that typically provide the information needed for the eligibility determination. However, this abbreviated process may result in some of the assessment domains in the UCAT that are used for service plan development being left blank or having limited information.
As a result of this expedited process and the transmission of potentially incomplete UCATs for approved ADvantage Members, Case Managers are to ‘Duplicate’ the MSU Nurses’ UCATs then complete any blank or missing areas/domains prior to service plan development. This completed UCAT must be saved as an Initial UCAT. The presence of a fully completed Initial UCAT is required for authorization of the case management service line on Members’ initial service plans.
In addition, the Home Care RN is to complete the Medication list on the RN evaluation and update the Medications tab as needed.
To support Case Managers in assuming the responsibility of completing any blank areas of the UCAT during this temporary process change, 25 additional case management units may be added to all first-year service plans submitted on or after 10/25/2021.
As Home Care RNs will be required to complete the Medication list for new waiver Members, two (2) units should also be added to the service line for RN Assessment & Evaluation (T1002).
As a reminder, the additional workload and corresponding units are a temporary process change affecting first year service plans only and will cease when MSU Nurses resume completion of the full UCAT document. Providers will be informed prior to the return to the normal business practice.
Please submit any questions regarding this information through the Provider Question chapter in Harmony.
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
