CMS recently issued a requirement related to the settlement of the 2013 Jimmo v. Sebelius class action lawsuit. The settlement addresses the delivery of skilled nursing services to Medicare beneficiaries and applies to nursing facilities, home health and outpatient therapy benefits when a beneficiary needs skilled care in order to maintain function or to prevent or slow decline or deterioration (provided all other coverage criteria are met).
All Medicare providers are required to review this training in order to ensure that services are provided and coverage determinations are adjudicated accurately and appropriately in accordance with existing Medicare policy. Please click on the link below to access the training materials.
Effective 12/31/2018, the Ohio Department of Medicaid (ODM) and Buckeye Health Plan (Buckeye) will implement new signature requirement for MyCare waiver services. On and after that date, waiver service providers will be required to sign the individual’s person-centered service plan (service plan). This change meets the Centers for Medicare and Medicaid Services’ (CMS) 42 CFR 441.301 rule requiring the service plan “be finalized and agreed to, with the informed consent of the individual, in writing, and by all people and providers responsible for its implementation.”
The provider’s signature confirms that the provider acknowledges and agrees to provide the waiver service, as authorized in the waiver service plan. The signed service plan must be completed and returned to Buckeye to ensure timely payment for services. Requirements will vary depending upon the services provided.
Please watch the video presentation below with voice-over narration or view a PDF of the presentation.
If you are not able to attend one of our Instructor-led Orientation webinars on Tuesdays and Thursdays at 11:00 a.m. to 12 p.m. from November 10 through August 31, 2021, please download the OnDemand PDF of the slides we've created for your convenience.