End of Appendix K Flexibilities and ADM Revisions: A yield sign that says "changes ahead" appears before a blue, sunny sky.

ADDITIONAL END OF PHE GUIDANCE

END OF APPENDIX K FLEXIBILITIES AND ADM REVISIONS 

OPWDD announced its updated guidance on the end of Appendix K flexibilities and ADM revisions. The following updates are effective as of November 11, 2023: 

  • 06-ADM-01R—Update 06-ADM-01 Group Day Habilitation ADM to reflect the end of the flexibility to provide day habilitation services within a certified residential setting.
  • 21-ADM-02R—Minor changes to provide billing identifier information for in-residence Community Habilitation-Residential (CH-R) and CH-R delivered via telehealth. 
  • 23-ADM-08—Update 2015-ADM-01 Community Habilitation ADM to include CH-R (21-ADM-02). Add in-residence CH-R as a long-term service delivery option for qualifying individuals.
  • 21-ADM-03R—Minor changes to provide billing identifier information for certain HCBS when delivered via telehealth. All Life Plans must be updated to reflect the use of remote technology as soon as possible, but no later than April 11, 2024. 

PARTNERS IN IMPLEMENTATION

ACA/NY and LIFEPlan are partnering with providers to proactively implement the revised guidance for our shared Members. As a reminder, for Members identified as potentially benefiting from services delivered via telehealth, that preference must be discussed with them in a person-centered way, and the Care Manager must complete The Evaluation to Receive Home and Community-Based Services (HCBS) via Remote Technology. This evaluation must be completed before amending the Life Plan to reflect the agreement to use remote technology to deliver HCBS waiver services. 

CARE MANAGERS ENSURE CHOICE

Care Managers actively engage Members in person-centered conversations and ensure their preferences are documented promptly. In upcoming Provider Relations meetings, the Directors of Provider Relations will further support Providers to assist with this process. Visit online for in-depth guidance. 

If you have questions about the end of Appendix K flexibilities and ADM revisions, contact Provider Relations online or contact a director in your region.