Mark YES if the AE has a protocol that contains all required elements. Mark NO if the AE does not have a protocol or not all required elements exist. NOTE - Identify whether there is no protocol or what elements are missing. 21a. Documentation was located. R The AE has located the Auto-authorization protocol. Mark YES if documentation was located. Mark NA if no remediation action is required or another remediation action was selected. AE OA, Section 6.16 21b. The AE develops a protocol that contain all required elements R The AE develops a protocol that contains all the required elements as outlined in the Operating Agreement. Mark YES if the AE develops a protocol that contain all required elements. Mark NA if no remediation action is required or another remediation action was selected. AE OA, Section 6.16 21c. Other remediation action R The reviewer can accept documentation of "other" remediation actions taken by the AE to comply with the requirements of the Operating Agreement. The reviewer records in comment field the REMEDIATION ACTION (RA) taken by the AE to remediate. Mark YES if the AE submitted remediation documentation. Mark NA if no remediation action is required or another remediation action was selected. AE OA, Section 6.16 21d. If YES, when: R The reviewer calculates the number of days between the notification date to the AE and the remediation action date. The reviewer chooses the appropriate time frame from the drop down. Mark NA if no remediation action was necessary or if no remediation action was taken by the AE. AE OA, Section 6.16 21e. Remediation action outstanding - referred to appropriate staff for follow up. R Mark YES if referred for appropriate follow-up as a result of no remediation action within 90 days of notification of the review findings. Utilize the comment field to record follow-up action. Mark NA if the issue was remediated or if no remediation was required. AE OA, Section 6.16
54a. Documentation was located. R The AE has located the completed Waiver reevaluation tool. Mark YES if missing documentation was located. Mark NA if no remediation action is required or another remediation action was selected. ODP Announcement 073-17, Public Comment Opportunity: Draft Bulletin on Individual Eligibility for Consolidated and P/FDS Waiver Services ODP Announcement 079-17, Issuance of the Correct Waiver LOC Reevaluation Form Waiver Renewal Implementation: Webinars for AEs – Individual Eligibility for Medicaid Waivers Bulletin 54b. Waiver reevaluation tool was completed, eligibility criteria was met, LOC completed, and HCSIS amended as appropriate. R The AE completed a Waiver reevaluation tool. QDDP completes a level of care determination. Mark YES if completed. Mark NA if no remediation action is required or another remediation action was selected. ODP Announcement 073-17, Public Comment Opportunity: Draft Bulletin on Individual Eligibility for Consolidated and P/FDS Waiver Services ODP Announcement 079-17, Issuance of the Correct Waiver LOC Reevaluation Form Waiver Renewal Implementation: Webinars for AEs – Individual Eligibility for Medicaid Waivers Bulletin 54c. Waiver reevaluation tool was completed, eligibility criteria was not met, disenrollment procedures have been initiated as per ODP policies and HCSIS amended as appropriate. R The AE completed a Waiver reevaluation tool. If the determination is that the person DOES NOT meet eligibility criteria, the AE must initiate disenrollment procedures per ODP policies and procedures, which includes notification to the person of hearing and appeal rights. Mark YES if HCSIS eligibility screen is amended to reflect disenrollment. Mark NA if no remediation action is required or another remediation action was selected. ODP Announcement 073-17, Public Comment Opportunity: Draft Bulletin on Individual Eligibility for Consolidated and P/FDS Waiver Services ODP Announcement 079-17, Issuance of the Correct Waiver LOC Reevaluation Form Waiver Renewal Implementation: Webinars for AEs – Individual Eligibility for Medicaid Waivers Bulletin