APRIL 21, 2022 | COMMUNICATION BULLETIN 2021-22 ISSUE 57 IN THIS ISSUE: Q&A Webinar for Vaya Health Network Providers | Update: COVID-19/PHE Rate Extensions and Benefit Plan Rate Schedule Updates | Vaya Health Provider Advisory Council Systemic Barriers Survey | Reminder: Federal Substance Abuse Prevention and Treatment Block Grant: Women’s Set Aside Training for Providers and LME/MCOs
Q&A Webinar for Vaya Health Network Providers Tomorrow, April 22, 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 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. Topics for this week’s webinar include legislative and policy updates, COVID-19/PHE rate extensions, and Tailored Plan contracting.
Q&A WEBINAR FOR VAYA NETWORK PROVIDERS – APRIL 22, 2022
Update: COVID-19/PHE Rate Extensions and Benefit Plan Rate Schedule Updates Vaya is extending COVID-19/PHE rate supplements for all eligible services through June 30, 2022, to align with the most recent federal extension of certain PHE measures. Please note the following service categories and COVID-19/PHE adjustment percentages: PRTF and behavioral health Long-Term Residential Services: 15% ICF/IID services: 15% Mobile Crisis and Crisis Stabilization services: 5% Outpatient and evaluation and management services by a licensed medical doctor, physician assistant, or nurse practitioner: 5% Community-based services, including Community Networking and Community Living and Support: 15% Supported Employment: 20% Assertive Community Treatment (ACT) Team, Psychological Rehabilitation, Peer Support, Respite, Individual and Supported Living, and related 1915(b)(3) services: 50%
For this extension, Vaya will provide the COVID-19/PHE supplement in additon to any other eligible rate adjustments, including the direct care worker (DCW), Intermediate Care Facility-DCW, and electronic visit verification (EVV) adjustments. For this reason, Vaya is updating the Medicaid(b) and (b)(3) rate schedules (non-clinician and clinician-based) and the Medicaid(c) rate schedule. The updated schedules will replace the most recent schedules, will be effective retroactive to April 1, 2022, and will be posted to the Rate and Checkwrite Schedules page of the Vaya Provider Central website by the end of the day tomorrow, April 22, 2022. Please refer to the updated schedules to confirm the rate supplement for each eligible service code. Please note that the COVID-19/PHE extension does not affect the Non-Medicaid Benefit Plan Rate Schedules, which were updated on April 1, 2022, and remain in effect. Modifiers to service codes, including the GT, CR, and GTCR combinations, are not specifically listed in the rate schedules but will remain valid through June 30, 2022. Services with these modifiers reimburse at the same rate as the base code and will include the COVID-19/PHE Rate Supplement through June 30, 2022. Please remember to make any necessary changes to billing systems, including changes in the HHAeXchange system for all EVV services, and to bill charges at or above the posted rates to receive the full unit reimbursement. Any claims for services previously filed and processed for payment may need to be refiled or reprocessed to earn the rate increases. Please contact your Claims Specialist for assistance with previously filed claims. For more information on Vaya rate schedules, email provider.info@vayahealth.com.
Vaya Health Provider Advisory Council Systemic Barriers Survey The Provider Advisory Council (PAC) is working to identify systemic barriers to providing quality services and to propose solutions to assist providers and increase desired outcomes among members and recipients. We encourage all Vaya network providers to complete the PAC’s ongoing Systemic Barriers Survey . The survey takes approximately four minutes to complete. As needed, the PAC’s Barriers Subcommittee will convene to review patterns of concerns and proposed solutions with Vaya leadership and subject matter experts. The status and results of this process will be a standing agenda item at monthly PAC meetings. Please note: To submit a provider-specific grievance or complaint, please contact the Grievance Resolution & Incidents Team at 1-800-893-6246, ext. 1600, or ResolutionTeam@vayahealth.com.
LEARNING OPPORTUNITIES Reminder: Federal Substance Abuse Prevention and Treatment Block Grant: Women’s Set Aside Training for Providers and LME/MCOs April 27, 2022, 10 a.m.-12 p.m. Registration remains open for this two-hour training, which will provide essential information about the federal Substance Abuse and Mental Health Services Administration (SAMHSA) Substance Abuse Prevention and Treatment Block Grant (SAPTBG) funds with a focus on Women’s Set Aside funding. We strongly encourage all SAPTBG providers in the Vaya network to join us for this opportunity to learn more about the following topics:
Purpose of the funds Funding requirements Restrictions on use of funds Specialized populations that must be prioritized “Set Asides” and special categorical requirements Maintenance of effort requirements PLEASE NOTE: Registrants can choose to receive two credit hours (CEUs) from the North Carolina Addictions Specialist Professional Practice Board. Registered attendees will receive the link to the training on April 25, 2022. Register online: SAPTBG Women's Set Aside Funding
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