14 Notify Providers Notify providers that were found to have the effect of isolating October 2017 December Notification to Presumed Not individuals. Inform these providers that they can demonstrate how the 2017 Providers Eligible and service currently meets the home and community-based characteristics Request Plan policy or they can submit a plan outlining how operation will be altered to meet the requirements for a home and community-based setting. 15 Provider Plan Timeframe for providers to develop and submit information requested in January 2018 March 2018 Provider Tracking Submission the letter referenced above and the home and community-based Tool characteristics policy. 16 Develop Identify and develop safeguards to preclude reimbursement for ineligible January 2018 October 2018 HCBS IT Changes Safeguards providers after the transition completion date. List 17 Review Information submitted by providers regarding how they meet or will April 2018 July 2018 Provider Tracking Submitted make changes to their program to meet the requirements for an eligible Tool setting will be reviewed. 18 Notify Providers of Notify providers of BAS’s initial decision regarding the setting’s eligibility. August 2018 September Notification to Decision Information regarding providers determined to be eligible will be 2018 Providers submitted to CMS for heightened scrutiny. Providers determined to be ineligible will be provided appeal rights. Providers will be expected to comply with applicable 55 Pa. Code Chapter 51 requirements. 19 Notify Participants Notify participants served by providers determined to be ineligible and August 2018 September Notification to of Decision Supports Coordination Agencies of provider ineligibility and what actions 2018 Participants participants may expect. The Individual Support Plan team must discuss the option of other willing and qualified providers or other services that will meet the participant’s needs and ensure their health and safety. The Supports Coordinator will be responsible for documenting this discussion. 20 Public Notice Issue a public notice which lists all settings/providers with the October 2018 November Public Notice determination of whether they are ineligible or will go through the CMS 2018 heightened scrutiny process for public comment.
14 Notify Providers Presumed Not Eligible and Request Plan Notify providers that were found to have the effect of isolating individuals. Inform these providers that they can demonstrate how the service currently meets the home and community-based characteristics policy or they can submit a plan outlining how operation will be altered to meet the requirements for a home and community-based setting. October 2017 December 2017 Notification to Providers 15 Provider Plan Submission Timeframe for providers to develop and submit information requested in the letter referenced above and the home and community-based characteristics policy. January 2018 March 2018 Provider Tracking Tool 16 Develop Safeguards Identify and develop safeguards to preclude reimbursement for ineligible providers after the transition completion date. January 2018 October 2018 HCBS IT Changes List 17 Review Submitted Information submitted by providers regarding how they meet or will make changes to their program to meet the requirements for an eligible setting will be reviewed. April 2018 July 2018 Provider Tracking Tool 18 Notify Providers of Decision Notify providers of BAS’s initial decision regarding the setting’s eligibility. Information regarding providers determined to be eligible will be submitted to CMS for heightened scrutiny. Providers determined to be ineligible will be provided appeal rights. Providers will be expected to comply with applicable 55 Pa. Code Chapter 51 requirements. August 2018 September 2018 Notification to Providers 19 Notify Participants of Decision Notify participants served by providers determined to be ineligible and Supports Coordination Agencies of provider ineligibility and what actions participants may expect. The Individual Support Plan team must discuss the option of other willing and qualified providers or other services that will meet the participant’s needs and ensure their health and safety. The Supports Coordinator will be responsible for documenting this discussion. August 2018 September 2018 Notification to Participants 20 Public Notice Issue a public notice which lists all settings/providers with the determination of whether they are ineligible or will go through the CMS heightened scrutiny process for public comment. October 2018 November 2018 Public Notice
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