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3%
Raise for Providers, Retroactive to July 1, 2006
The raise must first go through both a
federal and state approval process. Once approval is complete, all current
Consumer Directed Attendant Care (CDAC) providers will receive a 3% raise, not to exceed the maximum hourly
rate of $13.08 or the maximum daily rate of $76.28. The raise will be
retroactive to July 1, 2006.
3%
Increase in Waiver Funding for Consumers
The increase must first go through both a
federal and state approval process. Once approval is complete, the monthly
maximum for the waiver programs will be increased by 3%.
Clearer Payment Timelines for Claims Without Errors
CDAC claims must be adjudicated in 3 to 5
business days from the time they are received at Iowa Medical Enterprises
(IME). If a claim has no
errors, and is ruled upon by Friday, it will be paid by the following week
(paper checks are sent Wednesday, direct deposit on Thursday). If it is
not ruled upon by Friday, it will require an additional week to be paid.
Faster Resolution of Claims Denied Due to IME Errors
If a claim is denied due to an error by
IME, and the original claim form was filled out correctly, the provider
may call IME and correct the error over the phone. Providers are still
required to resubmit a paper claim if an error is made at the fault of the
provider.
Improved Back-Up Care Policies
A care plan can include substitute
providers who may provide services “on an occasional” basis
or as done previously on a “regular basis in lieu of the regular
provider.”
Provider Registry
DHS will create a registry of providers
as soon as possible but no later than June 30, 2007, which allows
consumers to seek out providers, and providers to find back-up care. The
registry will identify which providers are accepting additional consumers.
If a consumer requests a referral, state employees will refer that
consumer to the registry. The state will also make referral agencies aware
of the registry.
Electronic Filing of Claims
DHS will implement a system that allows
providers to submit their claims over the internet as soon as possible,
but no later than June 2007.
Clear
Problem-Solving Process
If a provider’s rights under this
agreement are violated he or she has access to a grievance process for
resolving the problem, with defined timelines; leading to neutral
mediation and binding arbitration when necessary.
Steps
Toward Health Insurance
The state will work with the union to
explore health insurance options. The state has applied for a Medicaid
grant that, if approved, will be applied toward a health insurance fund
for providers.
Education and Training
The state will distribute an orientation
packet to all new providers and make it available to current providers.
The union and the state will meet to discuss in-service trainings to be
made available to providers. Possible areas of training could include:
safety and health, current medical issues, and waiver program issues.
Voice
in Decisions
We will meet with the state on a
quarterly basis to discuss any matters pertaining to the waiver program.
Also, providers will have input in changes to the provider manual and
handbook.
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