Assistive Care Services and Assisted Living for the Elderly Waiver

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UPDATE LOG ASSISTIVE CARE SERVICES AND ASSISTED LIVING FOR THE ELDERLY WAIVER SERVICES COVERAGE AND LIMITATIONS HANDBOOK How to Use the Update Log Introduction Changes to the handbook will be sent out as handbook updates. An update can be a change, addition, or correction to policy. It may be either a pen and ink change to the existing handbook pages or replacement pages. It is very important that the provider read the updated material and file it in the handbook as it is the provider’s responsibility to follow correct policy to obtain Medicaid reimbursement. Explanation of the Update Log The provider can use the update log to determine if all handbook updates have been received. Update No. is the number that appears on the front of the update. Effective Date is the date that the update is effective. Instructions 1. Make the pen and ink changes and file new or replacement pages. 2. File the cover page and pen and ink instructions from the update in numerical order after the log. If an update is missed, write or call the Medicaid fiscal agent at the address given in Appendix C of the Medicaid Provider Reimbursement Handbook, HCFA-1500 and Child Health Check-Up 221 and the Medicaid Provider Reimbursement Handbook, Non-Institutional 081. UPDATE NO. EFFECTIVE DATE July 2001 New Handbook July 2001
ASSISTIVE CARE SERVICES AND ASSISTED LIVING FOR THE ELDERLY WAIVER SERVICES Coverage and Limitations Handbook Table of Contents Chapter and Topic Page Introduction Handbook Use and Format ...........................................................................................ii Characteristics of the Handbook....................................................................................iii Handbook Updates.......................................................................................................iv Part I – Assistive Care Services Chapter 1 - Purpose, Background, and Program Specific Information Overview ......................................................................................................................1-1 Description and Purpose ...............................................................................................1-2 Provider Qualifications and Responsibilities ....................................................................1-4 Part I – Assistive Care Services Chapter 2 - Covered Services, Limitations, and Exclusions Overview ......................................................................................................................2-1 Requirements to Receive Services..................................................................................2-1 Covered Service............................................................................................................2-5 Assessments for ALF and AFCH Residents...................................................................2-6 Service Plans for ALF and AFCH Residents..................................................................2-7 Assessments for RTF Residents.....................................................................................2-11 Treatment Plans for RTF Residents................................................................................2-13 Leave of Absence and Discharge ...................................................................................2-14 Termination of Services..................................................................................................2-15 Part I – Assistive Care Services Chapter 3 - Procedure Codes and Fees Overview ......................................................................................................................3-1 Reimbursement Information............................................................................................3-1 Appendix A: Procedure Code Table and Fees ..............................................................A-1 Appendix B: Appeal Rights and Fair Hearing Process....................................................B-1 Appendix C: Certification of Medical Necessity Form...................................................C-1 Appendix D: ACS Service Plan Form and Instructions ..................................................D-1
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