from DDRS: Recently it was brought to the Bureau of Developmental Disabilities Services’ (BDDS) attention that some waiver participants are receiving coverage denial letters from their current or prior private insurance carriers for services provided under the Community Integration and Habilitation (CIH) or Family Supports (FS) waivers. This process does not impact eligibility for waiver services nor does it interrupt or have any other effect on existing waiver services. The Office of Medicaid Policy & Planning (OMPP) is sharing the below information to help clarify the billing activity taking place: Under federal law, state Medicaid programs are intended to be the “payer of last resort.” Therefore, Medicaid agencies are required to pursue third party reimbursements where third party coverage may be available to pay for a claim paid by Medicaid. In the Medicaid application, the applicant/member assigns their right of recovery from third party liabilities to the State and a
Formerly Family Voices IN/About Special Kids. We provide answers and resources to families and professionals who are involved in the upbringing of children with complex medical conditions, mental health diagnoses and physical/intellectual disabilities.