pcb-05-11-23-issue-54

MAY 11, 2023 |

MAY 11, 2023 |

COMMUNICATION BULLETIN 2022-23 ISSUE 54

COMMUNICATION BULLETIN 2022-23 ISSUE

IN THIS ISSUE: IN THIS ISSUE: Provider Touchpoint | Open Office Hours for Providers | Reminder: Vaya Health PAC Systemic Barriers Survey | Upcoming Expiration of Appendix K Flexibilities | Telehealth Service Codes with CR or GTCR Modifiers Lapsing | Provider Portal Trainings | Permanent Supportive Housing (PSH) Training | Person-Centered Thinking Training | Save the Dates: Upcoming Innovations

Waiver Processes Trainings for TCM Providers

ALL NETWORK PROVIDERS NETWORK PROVIDERS

Provider Touchpoint Provider Touchpoint

Tomorrow, May 12, 2023, 11 a.m.-12 p.m.

Tomorrow, May 12, 2023, 11 a.m.-12 p.m.

The Provider Touchpoint webinar is your source for the latest information on topics that affect Vaya Health 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

PROVIDER TOUCHPOINT– MAY 12, 2023

PROVIDER TOUCHPOINT– MAY 12,

Open Office Hours for Providers Open Office Hours for Providers

Vaya continues to offer virtual open office hours for providers three days a week in May 2023

Providers are invited to drop in to ask questions related to doing business with Vaya. Subject matter experts on multiple topics will be available each session to answer your questions

To join, please select the link below:

May 16, 2023, 9-11 a m

May 16, 9-11 a m

May 17, 2023, 11 a.m.-1 p.m.

May 17, 11 a.m.-1

May 18, 2023, 1-3 p m

May 18, 1-3 p m

May 23, 2023, 9-11 a.m

May 23, 9-11 a.m.

May 24, 2023, 11 a m -1 p m

May 24, 11 a m -1 p m

May 25, 2023, 1-3 p.m

May 25, 1-3 p.m.

Vaya will announce additional open office hours in future Provider Communication Bulletins

Reminder: Reminder: Providersmaynotdiscussmember/recipientprotectedhealthinformation(PHI)during

thesecallsduetothepresenceofmultipleVayastaffandotherproviders.

Reminder: Vaya Health PAC Systemic Barriers Survey

Reminder: Vaya Health PAC Systemic Barriers Survey

The Provider Advisory Council (PAC) is working to identify systemic barriers to providing quality services and to propose solutions to help providers and increase desired outcomes among members and recipients.

We encourage all Vaya network providers to complete the PAC’s ongoing

We encourage all network providers to complete the ongoing Systemic Barriers Survey Systemic Barriers Survey. . The survey takes approximately five minutes to complete The survey five 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, contact Vaya’s Grievance Resolution & Incidents Team at 1-800-893-6246, ext. 1600, or ResolutionTeam@vayahealth.com ResolutionTeam@vayahealth.com.

BEHAVIORAL HEALTH, I/DD, AND TBI PROVIDERS BEHAVIORAL HEALTH, I/DD, AND TBI PROVIDERS

Upcoming Expiration of Appendix K Flexibilities

Upcoming Expiration of Appendix K Flexibilities

Today, May 11, 2023, marks the end of the federal COVID-19 Public Health Emergency (PHE) NC Medicaid’s NC Innovations Waiver Appendix K flexibilities are approved for six months after the end of the federal PHE, meaning they will end Nov 11, 2023 On that date, the flexibilities currently allowed under Appendix K will revert to the original authority/approved limits in the Innovations Waiver and Clinical Coverage Policy 8P

NC Medicaid plans to add language to a draft Innovations Waiver amendment to make some Appendix K flexibilities permanent. Those flexibilities would include:

Allowing Home-Delivered Meals

Removing the requirement that beneficiaries attend the Day Supports facility once per week

Allowing direct care services to be provided in a hotel, shelter, church, or alternative facilitybased setting or home of a direct care worker due to COVID-19-related issues

Allowing real-time, two-way interactive audio and video telehealth for Community Living and Supports (CLS), Day Supports, Supported Employment, Supported Living, and Community Networking

Allowing parents of minor beneficiaries to provide CLS if the minor meets criteria for having an exceptional need (“exceptional need” criteria remain under review and may include having the highest Supports Intensity Scale [SIS] level)

The proposed changes would require approval from the U S Centers for Medicare & Medicaid Services (CMS).

Telehealth Service Codes with CR or GTCR Modifiers Lapsing Telehealth Service Codes CR or GTCR Modifiers Lapsing

As announced in our Provider Touchpoint webinar on April 14, 2023, service codes with the modifier CR or GTCR (for telehealth) will lapse due to the expiration of the COVID-19 PHE today, May 11, 2023. They will no longer be available for use except for services allowed under Innovations Waiver for services allowed under Innovations Waiver

Appendix K

Appendix K flexibilities

LEARNING LEARNING AND PARTICIPATION AND PARTICIPATION OPPORTUNITIES OPPORTUNITIES

Vaya is offering trainings to help providers navigate our new Provider Portal Provider Portal Registration is not required. Provider Portal job aids are also available on the Resources page of our Provider Central website

UPCOMING TRAININGS UPCOMING TRAININGS

Provider Portal Authorizations: May 18, 2023, 10 a.m.-12 p.m. Join online online.

Provider Portal Authorizations: May 25, 2023, 10 a m -12 p m Join online online

Permanent Supportive Housing (PSH) Training Permanent Supportive Housing (PSH) Training

June 15, 16, 22, and 23, 2023, 9 a.m.-1:30 p.m.

June 15, 22, and 23, 2023, 9 a.m.-1:30 p.m.

Vaya will host a free, virtual training to help Community Support Team (CST) and Assertive Community Treatment (ACT) providers within the Vaya, Alliance Health, and Partners Health Management regions understand and improve their practice of the PSH model

To receive credit for the training, you must attend all four days Participants are required to have their camera on and audio capability. Due to limited capacity, only three staff members from each provider organization may participate

To register, RSVP on the event page on Vaya’s website event on Vaya’s website Participants will receive a link to the training the week before the event For more information, email provider training@vayahealth com provider training@vayahealth com

Person-Centered Thinking Training Person-Centered Thinking Training

Person-Centered Thinking is a two-day, 12-hour virtual workshop that introduces the principles and use of person-centered thinking Participants must attend on both days to receive a certificate of completion Vaya trainers will review and discuss the origins, research, and values of person-centered thinking.

Please note that due to limited capacity, only three staff from a single organization may attend. Include staff members’ full name and email address in the RSVP Register online Register online

Save the Dates: Upcoming NC Innovations Waiver Processes

Save the Dates: Upcoming NC Innovations Waiver Processes Trainings for TCM Providers Trainings for TCM Providers

Vaya will present NC Innovations Waiver processes trainings on the following dates for Tailored Care Management (TCM) providers serving waiver participants:

July 20, 2023, 9-11 a m Join online online

July 25, 2023, 10 a.m.-12 p.m. Join online. Join Aug 2, 2023, 8:30-10:30 a m Join online Join Aug. 8, 2023, 2-4 p.m. Join online. Join

Each training will be a unique module. Care managers working with Innovations Waiver participants should attend all four trainings We will record the trainings for individuals who cannot attend and to help train future staff. Vaya will provide more details about the training content in an upcoming Provider Communication Bulletin

Why did I receive this email? Why did receive this email? Vaya Health requires all network providers to subscribe to our Provider Communication Bulletin. For more information, reference our Provider Operations Manual Provider Operations Manual.