DDARS Home- and Community-Based Services Waivers (IHCP Provider Reference Module, PRPR10014)

What this rule requires your agency to do

• 1Waiver providers (type 32) must bill professional claims using their IHCP-assigned Provider ID (not an NPI); where a unit equals 15 minutes, a minimum of eight minutes must be provided to bill one unit; the FFS timely filing limit is 180 days from the date of service.(DDARS Home- and Community-Based Services Waivers (IHCP Provider Reference Module, PRPR10014))
• 2A TB test is required for all direct care employees upon hire prior to face-to-face client interaction (stored in the personnel file), with yearly TB education and an updated test upon known exposure (negative X-ray if positive).(DDARS Home- and Community-Based Services Waivers (IHCP Provider Reference Module, PRPR10014))
• 3H&W and TBI providers must give at least 30 calendar days' written notice before terminating waiver services; FS and CIH providers must give at least 60 calendar days' notice.(DDARS Home- and Community-Based Services Waivers (IHCP Provider Reference Module, PRPR10014))
• 4Direct service staff must receive First Aid and CPR training and demonstrate CPR competency through certification upon hire prior to face-to-face client interaction.(DDARS Home- and Community-Based Services Waivers (IHCP Provider Reference Module, PRPR10014))
• 5An individual with a conviction described in 460 IAC 6-10-5 (FS/CIH) or 455 IAC 2-15-2 (H&W/TBI) is not eligible for hire; the minimum accepted background is a limited criminal history check, and providers may not provide services before completion/review of the background check.(DDARS Home- and Community-Based Services Waivers (IHCP Provider Reference Module, PRPR10014))
• 6For high-risk enrollment category services (including Attendant Care and Specialized Medical Equipment and Supplies), all owners and managing individuals with 5% or more ownership or controlling interest must undergo a national fingerprint-based background check.(DDARS Home- and Community-Based Services Waivers (IHCP Provider Reference Module, PRPR10014))
• 7Providers must verify IHCP eligibility for each member on each date of service before initiating services, and must use an EVV system to document designated personal care services (exporting to the Sandata Aggregator if using an alternate system).(DDARS Home- and Community-Based Services Waivers (IHCP Provider Reference Module, PRPR10014))
• 8Direct care staff must be checked against the nurse aide registry maintained by the Indiana Professional Licensing Agency (per 455 IAC 2-6-2 and 460 IAC 6-10-5).(DDARS Home- and Community-Based Services Waivers (IHCP Provider Reference Module, PRPR10014))