The Bureau of Developmental Disabilities Services recently issued an announcement on June 28, 2021, regarding a 14% rate increase for the following services:
- Adult day services – Level 1, 2 and 3
- Prevocational services
- Respite
- Extended services
- Day habilitation – Individual and Group Small, Medium and Large
- Workplace assistance
- Transportation services – Level 1, 2 and 3
- Participant assistance and care
- Facility based support
- Residential habilitation and support (daily & hourly)
This communication is to correct and clarify the implementation date and billing options for providers.
The intent of these funds is to support the overall goal of increasing the statewide average direct support professionals wage to $15 an hour. Therefore, the rate increase requires an authorized service provider to use at least 95% of the amount of the increase in the reimbursement rate to pay payroll tax liabilities and to increase the wages and benefits paid to eligible direct care staff.
BDDS values the critical supports that our direct support professionals provide therefore we are moving to obtain approval to implement the rate increase as soon as possible. If approved by the Centers of Medicaid & Medicare Services the increased rates will be implemented and available in our systems to bill beginning on or after Aug. 1, 2021 and retroactively effective to July 1, 2021.
Provider billing options and implementation plans
Providers may continue to bill the current rate for the affected services throughout the month of July. When systems are updated to reflect the updated service rates and prior authorizations (Aug. 1, 2021), Gainwell will automatically reprocess the claims for these services to remit the 14% increase to providers.
Alternatively, providers may choose to wait to bill claims for these services until after Aug. 1, 2021, when the updates have been appropriately applied.
Providers of these services are encouraged to review the requirements for your agency to be able to benefit from these rate increases found here. The date for submission of provider plans for implementation of the rate increases has been extended to Sept. 1, 2021.
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