MARCH 31, 2022 | COMMUNICATION BULLETIN 2021-22 ISSUE 52 IN THIS ISSUE: Q&A Webinar for Vaya Health Network Providers | REMINDER: AlphaMCS Transition | Updated Standard Rate Schedules Available | Short-Term Assistance Funding for Group Homes | Attention: Day Support Provider Agencies Funded through ADVP, LTCS, or the NC Innovations Waiver | Transition of 1915(b)(3) Waiver Services | Person-Centered Thinking (PCT) Training
Q&A Webinar for Vaya Health Network Providers Friday, April 1, 2022, 11 a.m.–12 p.m. Join our biweekly Provider Q&A Webinars for the most up-to-date information on topics that affect Vaya network providers. We will address topics and questions specific to transitioning Cardinal Innovations providers at the end of the session. We encourage all network providers to attend. Registration is not required. The link to each webinar is published both the week prior to and the week of the event in the Provider Communication Bulletin.
Q&A WEBINAR FOR VAYA NETWORK PROVIDERS – APRIL 1, 2022
REMINDER: AlphaMCS Transition As announced in the Vaya Provider Communication Bulletin 2021-22 Issue 41 , published Jan. 25, 2022, Vaya will transition from a Wellsky-hosted version of AlphaMCS to an in-house version as Wellsky ends support for the AlphaMCS product. This change has been rescheduled to take effect on April 4, 2022. To prepare for the transition, Vaya will disable all provider AlphaMCS portal user accounts at 5 p.m. Friday, April 1, 2022. We will reactivate user accounts no later than 8 a.m. Monday, April 4, 2022. Vaya network providers will access the new AlphaMCS portal environment at https://alphamcs.vayahealth.com/portallogin. Please note that the new URL will not be active until April 4. This URL can be used for service authorization, claims processing, and provider profiles associated with Vaya. Users will not have the ability to access or submit information to other LME/MCOs through this URL. Beginning April 4, providers who direct submit 837 files to Vaya must use the SFTP connection information and credentials they received from Vaya in February.
The in-house AlphaMCS environment will be a duplicate of the current system. All data in the hosted version will remain available in the new system, and portal user IDs and passwords in use at the time of the transition to the in-house AlphaMCS system will not change. Vaya will use the in-house version until we move to a new claims processing application, Conduent HSP, expected later this year. Vaya will address questions regarding the AlphaMCS transition during our Q&A Webinar for Vaya Network Providers at 11 a.m. Friday, April 1, 2022.
Updated Standard Rate Schedules Available As communicated in the Vaya Provider Communications Bulletin 2021-22, Issue 49 , on March 10, 2022, Vaya is posting updated full benefit plan standard rate schedules that take effect tomorrow, April 1, 2022. The new schedules include all changes to service codes and unit reimbursement rates effective Jan. 1, 2022. For more information, please refer to the memo linked below. Read more: Memo: Updated Benefit Plan Rate Schedules Eff. April 1, 2022, and Limited COVID-19 Extensions
Short-Term Assistance Funding for Group Homes NCDHHS has allocated one-time funding to Vaya to provide short-term assistance funding for SFY2021-22 for individuals living in group homes in our region licensed under 10A NCAC 27G .5601 (c)(1) and 10A NCAC 27G .5601 (c)(3). To qualify, minor or adult residents must have a primary diagnosis of mental illness or I/DD and meet the criteria in the operational instructions below. Due to the limited funds allocated to Vaya for shortterm group home assistance, there is no guarantee of payment for the full fiscal year unless additional funds become available for this purpose. OPERATIONAL INSTRUCTIONS: Please use the following process to request use of short-term supplemental funds for any member(s) who meet the criteria below, which aligns with N.C. Session Law 2021-180 Section 9F.12: The resident was eligible for Medicaid-covered Personal Care Services (PCS) prior to Jan. 1, 2013. The resident was determined to be ineligible for PCS on or after Jan. 1, 2013, due to Medicaid State Plan changes in PCS eligibility per criteria in Section 10.9F of S.L. 2012-142, as amended by Section 3.7 of S.L. 2012-145 and Section 70 of S.L. 2012-194. The resident has continuously resided in a group home since Dec. 31, 2012. NOTE: The member may not receive this funding if PCS is being continued under maintenance of service requirements pursuant to a Medicaid appeal that was filed on their behalf. Funding may not exceed $464.30 per month per resident. Eligible expenditures must be incurred during the period between July 1, 2021, and June 30, 2022. REQUEST AND PAYMENT PROCESS: Eligible group home operators should complete all required sections of the Funding Sources Notification Form and the Invoice for Short-Term Group Home Assistance Payment and submit to STGHAssistance@vayahealth.com . Additionally, eligible group home operators must submit the Funding Sources Notification Form to NCDHHS at COVIDghfunding@dhhs.nc.gov. Once the forms are submitted, Vaya’s Housing Supports Team will contact group home operators to discuss any additional steps needed to receive payment. Depending on the number of individuals served by group home operator, a provider contract or contract amendment may be required. Vaya will remit payment based on our weekly checkwrite schedule.
Attention: Day Support Provider Agencies Funded through
ADVP, LTCS, or the NC Innovations Waiver NCDHHS’s Home and Community-Based Services (HCBS) Internal Team has been informed that some HCBS Day Support providers may be allowing work under the Fair Labor Standards Act Section 14(c) Subminimum Wage Certificate Program to be performed under prevocational activities. NCDHHS is requesting information from all LME/MCOs to better understand the frequency of this activity. To provide NCDHHS with the requested information, Vaya will be sending a brief questionnaire to network Day Support provider agencies funded through ADVP, LTCS, or the NC Innovations Waiver. Please be on the lookout for the questionnaire in your email inbox. The questionnaire must be completed by April 18, 2022.
Transition of 1915(b)(3) Waiver Services NCDHHS currently covers a subset of behavioral health services under Section (b)(3) of the approved North Carolina 1915(b) Medicaid Waiver, which will sunset upon Tailored Plan launch on Dec. 1, 2022. NCDHHS is seeking approval from the Centers for Medicare & Medicaid Services (CMS) to cover most of the current 1915(b)(3) services through a State Plan amendment approved under Section 1915(i) of the Social Security Act. Information on 1915(i) services is available in the NC Medicaid Transition of 1915(b)(3) Benefits to 1915(i) Authority white paper and the NC Medicaid article Transition of 1915(b)(3) Services to 1915(i) Authority, published March 25, 2022.
LEARNING OPPORTUNITIES Person-Centered Thinking (PCT) Training May 19-20, 2022, 9 a.m.–4 p.m. Vaya offers this two-day, 12-hour workshop to introduce the origins, principles, and use of person-centered thinking. Participants must be present both days to receive a certificate of completion. Each day’s schedule includes a 30-minute lunch break. Two weeks prior to the training, participants will receive the Microsoft Teams link and handouts required for the training.
REGISTER ONLINE
VAYA HEALTH | vayahealth.com | providers.vayahealth.com