waiver participant transfers · 2017. 7. 6. · planning the transition to new region the...

Waiver Participant Transfers

OAAS-TNG-17-006

Issued May 15, 2017

Louisiana Department of Health628 North 4th Street, Baton Rouge, Louisiana 70802

(225) 342-9500

Agency to Agency Transfers within Different Regions

OAAS-TNG-17-006 of 24Issued May 15, 2017

Transfers Between Regions

Support coordinators (SCs) need to routinely advise participants to notify their SC immediately of any plans to relocate.

This will help ensure services continue after the move without a lapse.

When moving from one region to another within the State of Louisiana, the participant will:

Contact Data Management Contractor (DMC) to request the “Support Coordination and Release of Information Freedom of Choice (SC FOC) Form”.

The participant will need to let the DMC know the region they will be moving to.

If the participant is unable to request the SC FOC form, their current SC can request the FOC on behalf of the participant.

Return the SC FOC form signed and dated to DMC.


Requesting the Freedom of Choice

The DMC will email the SC FOC, also referred to as the linkage, to the receiving Support Coordination Agency (SCA) and the receiving OAAS Regional Office (RO).

The receiving SCA will:

Send the SC FOC form to the transferring (i.e., current) SCA to arrange for transfer of records.

Assist with coordinating the transfer.


Planning the Transition to New Region

The transferring SCA will:

Offer a current FOC for each waiver service the participant is receiving (or requests) for the region he/she will be moving to.

Complete Plan of Care (POC) revision to update demographics and providers.

Demographics and providers, including the SCA, will reflect the new address/new providers/new SCA.

Send the following information to the chosen provider(s) so the provider can determine if they can meet the participant‘s needs:

Updated demographic POC page,

Signed FOC for the requested service, and

Signed flexible schedule.


Finalizing POC Revision

The transferring SC Supervisor will review and approve the POC revision packet. Ensure the following items are included:

POC demographic page with new address and contact information,

Budget Worksheet:

Be sure all provider names and provider numbers are correct and the units and total costs are correct.

POC Signature Page with all signatures and dates:

Date POC Approved is the actual date of SC Supervisor approval,

POC revision begin date is the projected move date,

POC revision end date, and

Date POC packet mailed to participant.


Finalizing POC Revision (cont’d)

The transferring SCA will submit the approved POC revision to the DMC including:

POC demographic page,

POC signature page, and

Budget worksheet.

Contact all transferring provider(s) to advise the last date of service and

Send the POC Revision to receiving provider.


Submitting Records to New SCA

The transferring SCA will send copies of the following information to the receiving SCA within seven (7) days of projected move date:

Current approved POC and all POC revisions,

Home health or hospice POC, if applicable,

Form 142,

Medicaid decision notice,

Support coordination document (SCDs) for last six (6) months,

Transfer e148-W, indicating new region/parish, move date and indicating agency transfer, and

Signed and dated SC FOC.


SC Processes in the Transferring Region

The transferring SCA will then:

Complete CMIS Closure Summary,

Submit e148-W to Medicaid office, and

Submit CMIS Closure Summary to DMC and RO.

The transferring SCA will provide services up to the date of transfer records and may bill for service after dated notification is received by the receiving SCA.

All assessments/POCs in process must be completed by the transferring SCA.

Transferring RO will email participant case record to the receiving RO upon this notification.


SC Processes in the Receiving Region


Sign and date the SC FOC (Section 5, Receiving Agency) on the date the records are received.

Contact the participant and/or RR within three (3) business dates to schedule a face to face meeting.

Conduct face to face meeting within 7 days of actual move. During the meeting, the SC will:

Gather necessary information and signatures on all SCA specific documents,

Review current POC/revisions and approved services with participant,

Complete Emergency Plan,

Request back-up staffing plan from DSP.


Finalizing the Transfer

The receiving SCA will submit the following documents:

SC FOC with both SCA signatures to DMC,

e148-W to Medicaid office,

Emergency plan, updated POC pages, if applicable, back up staffing plan, and SC FOC with both SCA signatures will be submitted to RO.

The receiving SCA may bill for services the first full month after the transfer of records.



(225) 342-9500

Agency to Agency Transfers within the

Same Region


Transfers Between Support Coordination Agencies

Participants must be linked to a SC for a six (6) month period before they can transfer to another SCA, unless there is good cause for the transfer.

The following extenuating circumstances may indicate good cause:

Participant moves to another region,

Support Coordination Agency (SCA) is closing,

Irreconcilable differences between the SCA and the participant.


Requesting the SC FOC

Participant must:

Contact RO to request SC FOC,

If RO determines the participant can select a new SCA, RO will request FOC form from the DMC for participant.

The participant will return the SC FOC form signed and dated to DMC.

DMC will email the SC FOC to the receiving SCA and the receiving RO.


Transfers Between SCA


Send the SC FOC to the transferring SCA to arrange for the transfer of records and

Submit e148-W to Medicaid Office & RO Within 3 days of receiving the SC FOC.

Section III. will need to indicate the transfer and linkage date.


Transfer of Records

The transferring SCA will send the receiving SCA the following documents within three (3) business days:

Current approved POC and all approved POC revisions,

Home health or hospice POC, if applicable,

Form 142,

Medicaid decision notice,

Support coordination document (SCDs) for last six (6) months,

Transfer e148-W, indicating transfer and linkage date, and

Signed and dated SC FOC.


Transfer of Records(cont’d)

The transferring SCA will:

Complete CMIS Closure Summary,

Submit e148-W to Medicaid Office, and

Submit CMIS Closure Summary to DMC and RO.


Receipt of Records


Sign and date the SC FOC, indicating in Section 5, Receiving Agency, the date the

records are received.

Contact the participant and/or RR within three (3) business dates of the receipt

of transfer records to schedule a face to face meeting.

Conduct the face to face meeting within seven (7) days of receipt of transfer

records.


Face to Face Meeting

During the face to face meeting, the receiving SC will:

Gathering necessary information and signatures on all SCA specific documents,

Review current POC and approved services with participant, and

Obtain participant’s signature on POC revision signature page.

Update POC demographic page and budget worksheet to reflect the new SCA and

Update any changes to POC, if needed.


Finalizing the Transfer

The receiving SC Supervisor will review and approve the POC revision packet, ensuring the following documentation is complete:


Budget Worksheet

Be sure all provider names and provider numbers are correct and the units and total costs are correct.

POC Signature Page:

Date POC Approved is the actual date of SC Supervisor approval,

POC revision begin date is the linkage date on SC FOC,

POC revision end date, and

Date POC packet mailed to participant.


Finalizing the Transfer (cont’d)

The receiving SCA will submit the approved POC revision to DMC including:


POC signature page,

Budget worksheet, and

SC FOC with both SCA signatures.




Submit the following completed documents to RO:


Updated pages of POC,

POC signature page,

Budget worksheet, and

SC FOC with both SCA signatures.

Submit copies of POC revision to the provider(s).

Mail a copy of POC revision to participant.



The transferring SCA will provide services up to the time of the transfer of records and may bill for services after dated notification is received by the receiving SCA.

All assessments and POC/revisions in process must be completed by the transferring SCA.

In the month the transfer occurs, the receiving SCA will begin services within 3 working days after transfer of records and may bill for services the first full month after transfer of records.



(225) 342-9500

Reference:

OAAS-MAN-13-007. Waiver Procedures Manual, reissued June 27, 2014. Sections P-110 and P-120.


waiver participant transfers · 2017. 7. 6. · planning the transition to new region the...

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