As previously announced, we received word from DSHS that they received final approval from CMS for the assisted living $9.30 rate add-on and retainer payments for assisted living, adult day health, and adult day care.

DSHS is planning to conduct webinars on Monday, May 4^th to review details including billing instructions to claim the add-on and retainer payments. We asked that these webinars be recorded but please make sure a representative from your organization attends, in case they are not.  We will send webinar details to all assisted living and adult day members as soon as we receive the webinar invite. 

DSHS created new service codes for the add-on and the retainer payments.  For the assisted living rate add-on the new service code has been authorized for all Medicaid clients and once it goes live you will need to go back to March 1, 2020 and submit a claim for each day that you previously billed.  You will not need to adjust any previously submitted claims.  This add-on is currently scheduled to sunset on June 30, 2020. Please note you will not submit an add on for anytime a resident was out of the facility, you will instead use the retainer payment. 

The retainer payments for AL, ADH, and ADC will cover 70% of your full rate and can be claimed for 30 consecutive days.  You will need to work with your case manager to receive authorization to claim retainer payments for any client that has left your facility to receive medical care due to COVID or for adult day programs if they are unable to come into your center because of the pandemic.  For adult day programs, you can claim the retainer payment for 30 consecutive days. Once the 30 days is up you will need to provide some type of service through the remote care waiver which could include home visits or remote wellness checks.  Once you have provided some type of service, you may claim the retainer payment for another 30 days.  Retainer payments are also scheduled to sunset on June 30, 2020.

DSHS is planning to release a Dear Provider letter and a management bulletin on Monday as soon as the service codes go live.  To ensure that all members receive these communications, we will forward them to you as soon as they have been released.

Questions?

Contact:

David Carter
Director Health Care Finance & Policy

LeadingAge Washington

c: 360.888.5702