June 6, 2016
2016 LegislativeRate Increases effective July 1, 2016 and another Bridgeview enhancement!
Blue Plus information and instructions related to the Minnesota Legislature authorized the following rate and limit changes for services provided on or after July 1, 2016. See DHS Bulletin 16-25-01 for more information.
- A 0.2 percent rate increase for Consumer Directed Community Supports (CDCS), Consumer Support Grant (CSG) and personal care assistance services (PCA)
- A 21.3 percent increase to Elderly Waiver (EW) and Alternative Care (AC) individual case-mix budget caps, Elderly Waiver customized living and 24-hour customized living service limits and CDCS monthly case-mix limits in EW and AC
- Transition from a monthly rate to a daily rate for EW customized living services and adult foster care.
- Mileage rate adjustment.
New dailyrate service codes will be available in Bridgeview on 07/01/16 for the following:
- T2031 Customized Living Services;
- T2031 TG 24-hour Customized Living Services;
- S5140 Foster Care, Adult Family;
- S5140 U9 Foster Care, Adult Corporate
Bridgeview Company will automatically complete all necessary updates starting Friday 6/17/2016 for alleffected existing service agreements and will be available early the week of 6/20/16. All service agreements impacted by the daily rate service code change will be closed with a 06/30/16 end date. For each service agreement that was systematically closed, a new service agreement will automatically be created with the same end date as the previous service agreement, the same provider name and UMPI/NPI number, and the new service code.While Bridgeview is updating service agreements your access will not be interrupted.
These new service agreements will be in “Pended” status until the Care Coordinator reviews the updates. For your convenience a list of the “Pended” services by Delegate agency will be available and sent out separately shortly after the automated updates are complete.
CC Action Required—
- Review each of your services agreements and update by July 1, 2016.
- Verify the end date, units and daily rates for the new service code that were converted from monthly to daily.
- After your review change the “Pended” status from “Yes” to “No.” If this is not done providers will not be able to view the updated service agreements with the new daily rate information.After the “Pend” status is changed from “Yes” to “No” a service agreement will be released to PDF format and sent to the Bridgeview Company website the next business day for the providers to view and or print.
- Please note: Any service agreements after the automation on 6/17/16 will require manual entry of two service agreements. One for the monthly rate and service code for dates of service prior to 6/30/16 and one for the new daily rate and service codes after 7/1/16.
- Care Coordinators are responsible to review the service agreements to ensure the member remains within their budget.
EW Individual Case Mix Budget Caps/Monthly CDCS Case Mix limits/EW Customized Living and 24-hour Customized Living Service Limit Increases
Care Coordinators may plan for changes to the member’s care plan at the time of the next reassessment orif the member experiences a change in condition. CCs may choose to update a person’s care plan sooner if doing so will better support the person to remain in the community and the plan is based on the person assessed needs, preferences, and choices.
For those planning for customized living, 24-hour customized living, foster care, or residential care and when making any updates to the plans for these services, use the newest version of Residential Services Tool which incorporates the new limits for all submissions after July 1, 2016. See DHS website for EW Customized Living, Foster Care and Residential Care web page for more information about completing and submitting an RS Tool.
CC Action required—
Care Coordinators who currently have members with approved exceptions to exceed the case mix budget capshould review to determine if the rate is now equal to or less than new case-mix budget cap. If the services are now within cap, you may withdraw the request and make any necessary updates in Bridgeview case mix section.
If the service plan continues to exceed the assigned case-mix budget cap, the Care Coordinator must continue obtain a reauthorization at least 30 days prior to the end of the current authorization period following the process outlined in the section Requests to Exceed Case Mix Budget Cap of the Care Coordination Guidelines for Community Members.
CC action NOT required for the following rate changes. All effected services agreements will automatically be updated:
- Transportation Commercial Vehicle Mileage rate decreased from $1.57 to $1.54
- Transportation Non-Commercial Vehicle Mileage rate decrease from .57 to .54.
- Extended PCA increase .02% (T1019 HQ UC, T1019 TT UC, T1019 UC)
- Consumer Directed Community Supports (CDCS) (T2028)
Another Bridgeview enhancement:
A new short-cut feature will automatically calculate the number of days between the “To” and “From” date span when creating a new service agreement.
- Enter the “To” and “From” date span,
- Add a “0” in the unitsfield. (The short-cut will only work if you add a “0” in the units’ field)
- Continue on to enter the service code rate, proration and “daily” for frequency.
- The Web Tool will automatically calculate the days between the “To” and “From” date span.
Please contact your Partner Relations Consultant with any questions.
Blue Cross® and Blue Shield® of Minnesota is a nonprofit independent licensee of the Blue Cross and Blue Shield Association