Medicaid Service Update

To:  All ADvantage Case Management Providers

Subject: CD-PASS – Rate Increase and NEW Budget Worksheet

Date: September 19, 2022

The Medicaid Services Unit (MSU) is pleased to announce the approval of the ADvantage Waiver Amendment by the Centers for Medicare and Medicaid Services (CMS).  The Waiver Amendment increases ADvantage service rates by 25% effective 10/01/2022.  

The new unit rates for the ADvantage self-directed service option, Consumer Directed Personal Assistance Services and Supports (CD-PASS), can be found below.  ADvantage CD-PASS authorizations will be converted systematically in Harmony.

Please note:  Individual PSA and APSA hourly wage rates will not be automatically adjusted for the rate increase. Case Managers will need to contact the CD-PASS Member and complete the steps outlined in this bulletin to increase the PSA/APSA hourly wage rate.

The CD-PASS Budget Worksheet has been updated to accommodate the unit rate increases for the ADvantage Program.  The new Budget Worksheet (Version 22, dated 10/01/2022) is now available in the Harmony Library site and the Financial Management Services (FMS) CD-PASS resource page.

The new Budget Worksheet must be used for all CD-PASS service requests beginning 10/01/22 or later.  The MSU can no longer accept the Budget Worksheet dated 12/11/2019. The new Budget Worksheet has been reworked to simplify the process and help increase understanding of the worksheet for Members and Case Managers.  

Every Member’s budget is different. The hourly maximum wage calculated on the Budget Worksheet includes all tax and worker’s compensation deductions as required by Federal/State law and the ADvantage Waiver.  The PSA/APSA maximum hourly wage cannot be determined by simply multiplying the 15-minute service unit rate by 4.

If a CD-PASS Member requests their PSA/APSA receive a wage increase during the Member’s current plan year as a result of the 10/1/2022 rate increase, a one-time hourly wage rate adjustment may be requested. Please follow the steps below to facilitate this adjustment.

STEPS TO REQUEST A PSA’s/APSA’s Hourly Wage Rate
Step 1: The Case Manager will need to attach a new Budget Worksheet to a Note in the Member’s Harmony case. The begin date must be 10/1/2022 or later and the end date must be the end of the Member’s service plan year.

• Note Type = CD-PASS,
• Note Sub-Type = CD-PASS Budget Worksheet,
• Note Status = Communication,
• Note Content = Plan adjustment per 10-1-2022 unit rate increase.

Step 2: The Case Manager will also need to attach a new PSA/APSA CD-PASS Employee Rate Form to a Note in Harmony. The form is available on the FMS website and in the Harmony Library.

• Note Type = CD-PASS,
• Note Sub-Type = CD-PASS Pay Rate Form
• Note Status = Communication,
• Note Content = Plan adjustment per 10-1-2022 unit rate increase.

Step 3: To submit the request, the Case Manager will need to email the MSU CD-PASS Helpdesk at cdpass@okdhs.org. Use the subject “CD-PASS Plan Adjustment – [Member's Harmony ID].” Do Not use the Member’s name or any other personally identifiable information.

NOTE:  Case Managers should NOT make any service plan changes nor should they submit the plan to MSU for SPA Review.

The Member’s T2025 Consumer-Directed Goods & Services (OPX) unit rate will be systematically adjusted in Harmony.  The total number of OPX units will remain the same and no changes will be made to the total number of OPX units currently authorized.

If you have any questions regarding this bulletin or other CD-PASS programmatic concerns, please submit a Provider Question in the Harmony System.

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