Arkansas Administrative Code › Agency 016 - DEPARTMENT OF HUMAN SERVICES › Division 06 - Medical Services › Rule 016.06.14-026 - Alternative for Adults with Physical Disabilities Waiver

Current through Register Vol. 49, No. 6, June, 2024
Section IIAlternatives for Adults with
			 Physical Disabilities Waiver
213.220
Benefit Limit Consumer-Directed Attendant Care
One unit of consumer-directed attendant care service equals a
				full 15 minutes. The established benefit limit for Alternatives Attendant Care
				Service is 11,648 units per state fiscal year. Services are reimbursable when
				provided according to the beneficiary's approved Plan of Care.
A maximum of 8 hours per day, 7 days per week is allowed,
				except that an individual provider may not work for more than 40 hours per
				week. An individual provider may work for only one beneficiary during a single
				day. The number of hours included on a beneficiary's Plan of Care is based on a
				medical assessment, the individual's needs and other support systems in
				place.
242.210
Billing Instructions for Agency and Consumer-Directed Attendant
Care Providers
The following instructions must be read and carefully followed
				so that HP Enterprise Services can efficiently process claims. Accuracy,
				completeness and clarity are important. Claims cannot be processed if
				applicable information is not supplied or is illegible. Claims should be typed
				whenever possible.
Regardless of the date that Attendant Care services begin for
				an Alternatives beneficiary, Medicaid reimbursement is not allowed prior to the
				effective date of the Medicaid Provider Identification Number (PIN) as issued
				by the Medicaid fiscal agent, HP Enterprise Services.
NOTE: It is very important to submit a completed provider
				certification packet
immediately. Each packet must include all of the required
				documents, tax forms and copies of identification as required for the
				individual service. Packets received and processed will establish a provider's
				eligibility as stated in this manual. Provider eligibility will not begin prior
				to the first day of the month that a correctly completed DAAS
				certification/Medicaid Attendant Care provider enrollment packet is received by
				DAAS. Therefore, packets must not be held and mailed in for processing at a
				later date.
For example, the waiver eligibility effective date for
				the Alternatives beneficiary is 1-15-07. The Attendant Care provider and the
				Alternatives beneficiary signed the Alternatives Attendant Care Service
				Agreement (AAS-9512) on 1-20-07. A correctly completed DAAS
				certification/Medicaid Attendant Care provider enrollment packet was received
				by DAAS on 2-10-07. Services provided on or after 2-1-07 will be eligible for
				reimbursement.
* The Attendant Care Service Agreement (AAS-9512) cannot be
				back dated.
* Once signed and dated by the provider and the waiver
				beneficiary, the Attendant Care Service Agreement (AAS-9512) must be postmarked
				within 14 calendar days of the signatures on the agreement.
* Prior to providing attendant care services, the provider must
				be certified by DAAS, possess an active Medicaid PIN issued on behalf of the
				Arkansas Medicaid Program and have a copy of the employer/beneficiary's current
				Plan of Care provided by the DAAS Rehab Counselor or RN.
Medicaid may be billed only for the amount of services
				authorized in the Alternatives Plan of Care and only for what the Attendant
				Care provider has actually provided. MEDICAID CANNOT BE BILLED FOR FUTURE DATES
				OF SERVICE. An individual provider may not work for more than 40 hours per
				week. An individual provider may work for only one beneficiary during a single
				day.
Following is the address and telephone number for the HP
				Enterprise Services Provider Enrollment Unit in the event there are questions
				about a PIN number:
HP Enterprise Services
Provider Enrollment Unit
PO Box 8105
Little Rock, AR 72203-8105
(501) 376-2211 or 1-800-457 -4454
Following is the address and telephone number for the HP
				Enterprise Services Provider Assistance Center in the event there are questions
				about a claim:
HP Enterprise Services Provider Assistance Center PO Box
				8036
Little Rock, AR 72203-8036 (501) 376-2211 or 1-800-457
				-4454
If an Attendant Care provider quits working for an Alternatives
				beneficiary, the DAAS RN/Counselor must be notified immediately in writing,
				citing the last day of employment.
242.311
Consumer-Directed Attendant
			 Care Services
When filing paper claims for Consumer-Directed Attendant Care,
				Form AAS-9559 must be used. Billing will be monitored to ensure compliance with
				the waiver Plan of Care. All billing will be reviewed based on the number of
				units authorized per week, Sunday through Saturday. When computing units, the
				provider must bill no more than the number of units authorized per week
				beginning on Sunday. The Consumer Directed Provider is limited to 40 hours of
				work per week. All reviews are conducted based on the number of units billed
				Sunday through Saturday each week. Units billed outside this timeframe and over
				the number of authorized units are subject to recoupment.
Regardless of the number of waiver beneficiaries for whom an
				Attendant Care provider works, no more than 40 hours per week are eligible for
				reimbursement consideration by the Arkansas Medicaid program. In addition, if
				an Attendant Care provider is employed by another waiver beneficiary OR another
				employer, all hours of employment will be considered when authorizing Attendant
				Care services for a waiver beneficiary. No more than a total of 40 hours per
				week including ALL employment, will be allowed for an Attendant Care
				provider.
Regardless of the number of providers a waiver beneficiary
				hires, no more hours than authorized on the waiver Plan of Care are eligible
				for reimbursement consideration by the Arkansas Medicaid Program. The Consumer
				Directed Provider is limited to provision of services to one client per
				day.