Medicaid Service Update

To:  All ADvantage Providers

Subject: Violation Review Committee (VRC) Complaint Form and Name Change

Date:  July 20, 2022

As introduced in the bulletin dated April 15, 2019, the Medicaid Services Unit – ADvantage Administration (MSU-AA) has a committee to review alleged violations of Policy, Conditions of Provider Participation and/or Program Service Standards.  The Case Management Violation Review Committee (CMVRC) has changed its name to the Violation Review Committee (VRC) to include allegations of violation by any provider type. 

Documentation and evidence regarding alleged violations should be submitted to the Violation Review Committee (VRC).  To assist with this process, a new form has been created in Harmony.

Please follow the steps below when submitting an alleged violation for review:

STEP 1:  Submission Information:

a.      Submit all information via a Harmony Provider Question (PQ), filling out all fields as normal. 

b.      Use Provider Name = ADvantage (Do not include the name of your agency in the Provider ID or Provider Name.  By placing "ADvantage" in the Provider Name, this ensures only MSU staff can read the submission.).

c.      Use Inquiry Type = Violation Review Committee (VRC) Referral

STEP 2:  Hover over File and select Save Inquiry/Incident.

STEP 3:  Select the Documentation Sub-tab:

STEP 4:  Once the page loads, hover over File and Select Add Documentation:

STEP 5:  Select Violation Review Committee (VRC) Complaint Report from the dropdown:

STEP 6:  Fill out the form in its entirety, then hover over File and select Save and Close.

If you have any questions regarding the information provided above, please feel free to contact us via Harmony Provider Question.     

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