Home Health Agency Care Plan and Claim Submission Changes Under the Connecticut Home Care Program for Elders (CHCPE)

The Connecticut Department of Social Services has issued its Provider Bulletin 2014-19 in March 2014, to notify home health agencies serving CHCPE clients of changes being made to the program.These changes will be implemented in a staggered approach throughout April 2014 and will impact how medical services are authorized and will appear on the client’s care plan.

The following is a summary of the changes being implemented to the program:

• Implementation of a new modifier, U2 One Time Only. This modifier will uniquely identify a care plan service that overlaps with another service order for the same time period, and is retroactive to dates of service July 1, 2013 and forward.
• Unique Provider Code with modifier Lists for one-time services are being added when authorized and will appear on the care plan for skilled nursing and medication authorization services.

In addition, DSS recently added a new service, Med Tech, effective January 1, 2014 to the home health fee schedule, which may be provided to a client with HUSKY and/or a CHC benefit plan. Two new Provider Code Modifier Lists have been added and will appear on the care plan, if applicable.

Additional changes are being developed to allow the Access Agency to make retroactive changes to the care plan without requesting that the provider recoup their claims. These changes will be made later in the year in conjunction with a PA mass adjustment process that will systematically adjust claims when a PA mass adjustment has been updated. Until this mass adjustment process is implemented, providers will continue to be required to recoup their claims paid due to periods of non-service.

Additional information can be found at the www.ctdssmap.com web site home page, under the “Important Messages, Welcome to the CT Home Care Program Implementation