Provider reverification process update
Provider reverification process update
The Bureau of Quality Improvement Services has concluded an initial pilot of the accredited provider reverification process for Medicaid Home-and Community-Based providers. Of the five providers who participated in the pilot, one had an annual review and four had a full reverification review.
BQIS convened the reverification workgroup, which includes the Indiana Association of Rehabilitation Facilities, Inc., the Arc of Indiana, provider representatives, as well as the pilot providers, to review the pilot results and obtain feedback on the process. Based on the feedback the following adjustments will be made:
- BQIS will obtain the Secretary of State status instead of the provider.
- The guidance will be clarified relative to when to submit the provider agreement.
In an effort to ensure an effective and streamlined process for all provider types and sizes, BQIS will conduct a second pilot of the accredited provider reverification process with a particular focus on providers who were approved by BDDS within the last three years or are serving less than 100 individuals.. At the conclusion of the pilot, BQIS will reconvene the reverification workgroup for additional feedback on the process. Based on the information from the pilot, BQIS will adjust the process, as necessary. The second pilot will launch in January of 2021. At the conclusion of the second pilot, BQIS will share any additional modifications to the process and when full implementation of the accredited reverification process is anticipated.
Important Elements:
Accredited providers: A BDDS waiver provider who has (or is pursuing) at least one of the services requiring accreditation and is accredited by one of the accrediting entities set forth in Indiana Code 12-11-1.1.11:
- The Commission on Accreditation of Rehabilitation Facilitates
- The Council on Quality and Leadership
- The Joint Commission on Accreditation of Healthcare
- The National Committee on Quality Assurance
- The ISO-9001 human services QA system
- The Council on Accreditation
BDDS services requiring accreditation:
- Adult Day Services (all levels)
- Case Management
- Day Habilitation (all levels)
- Extended Services
- Pre-Vocational (all levels)
- Residential Habilitation (all levels)
Post-pilot accredited provider review schedule: A provider’s reverification/annual review will be based on the date in which the provider was either approved by BDDS or the date the provider’s previous reverification (or prior re-approval) term ends. Each BDDS approved waiver provider will be reviewed during the year; however, BQIS will attempt to avoid scheduling an accredited provider’s review during the six months prior to the provider’s accreditation survey.
Non-accredited provider pilot details: Once the accredited provider review process moves to full implementation, BQIS will then conduct a pilot with non-accredited providers following a similar process. Additional details will be made available prior to the launch of that pilot.
BQIS is a program of the Division of Disability and Rehabilitative Services whose mission is to ensure quality supports are aligned with person-centered principles by leading strategic change that empowers people to live their good life. For questions related to this announcement, please contact BQIS.Help@fssa.in.gov.
The DDRS is a program of the Indiana Family & Social Services Administration. If you have questions about DDRS programs and services, visit us online at www.DDRS.In.gov