First, a quick reminder that Community Day Service providers (including those that provide workshops) must complete the "Illinois CV Provider Preparedness Self-Assessment" prior to re-opening August 1 (soft opening) or September 1. Please send your completed self-assessment to DHS.BQM@illinois.gov. We will cross-reference billing for August (or September) with having a self-assessment on file with BQM.
And, now, we have some updates straight from the Division's Bureau of Reimbursement and Program Support. If you have questions please feel free to contact George Bengel at George.Bengel@illinois.gov.
PAYMENT ADJUSTMENT FOR PROVIDERS ON ADVANCE AND RECONCILE
CILA providers on advance and reconcile payments are advised that your agency's July and August advance CILA payments are overstated and overpaid by approximately 25 percent (as described below). CILA providers on advance and reconcile will see a recoupment of these funds when your agency submits billing for actual CILA services for July and August. This means, the net remittance payment for September and October will be reduced by the July and August overpayment. When the rate and payment adjustments are completed the net reduction is anticipated, but is not guaranteed, to be about five to seven percent dependent on your agency's billing and circumstances.
The following explains the overpayment impacting providers on advance and reconcile:
- July and August Advance CILA Payments were generated when the May and June billing was completed. The rates in effect for May and June included additional staffing for coverage of the traditionally unfunded hours for attendance at community day services, and a COVID-19 rate increase of 10%.
- July and August actual rates have been adjusted to return to normal residential hours of funding, and the COVID-19 premium of 10% has been reduce to 5%.
- CILA Providers can, as of July 1, potentially bill 37U for up to 5 hours a day when an individual is participating in At-Home day program.
- In the future, CILA Rates will be adjusted retroactively by $1.00 Wage Reimbursement after Federal CMS approval is received. This is not reflected at this time.
There is no impact on CILA providers that are on post-payment. They will receive the correct remittance when their agency submits billing for July and August CILA services.
As a reminder, CILA providers always have the option of switching from advance and reconcile to post- payment. Please see the posted Information Bulletin at this link for further information: https://www.dhs.state.il.us/page.aspx?item=64724
FY 20 LAPSE PERIOD BILLING
We want to remind providers that all billing for FY 2020 (July 1, 2019 through June 30, 2020) services and supports must be submitted to ROCS by 5:00 PM Monday, August 17, 2020. Billing which is submitted by this date will process during the week of August 17. Accepted billing which results in a MOBIUS Remittance Report by the end of the week, will be paid through FY20 lapse period funding. Billing, and rebilling of previously rejected billing, submitted to ROCS after August 17 will be processed but may be directed to Court-of-Claims for payment.
90 DAY BED HOLD ISSUES
The DDD has received reports from a few CILA providers that the payment system did not calculate certain individual's CILA billing correctly and they did not receive payment for days 61 through 90. If your agency believes there is an inaccurate payment of bed hold days for an individual previously granted a 90 days bed hold please contact George Bengel at George.Bengel@Illinois.gov
The following information should be provided: Individual's name, social security number, date Bed Hold started, month(s) you believe Bed Hold did not properly calculate, agency name and agency contact information. The Division is working with our IT staff to determine the extent of the problem and correct it
DIVISION ISSUED SITE ID's
CILA Providers are reminded that ALL CILA sites require a DD Site ID Number, issued by the Division of Developmental Disabilities. This is necessary for an ISC to submit a CILA funding request to the DDD. DD Site IDs are separate from the approval and Site ID issued by the Bureau of Accreditation, Licensure and Certification (BALC), which is not within the Division. DD Site IDs are required for all CILA sites including, but not limited to, Individually controlled sites, Intermittent and Family Intermittent CILA.
The process and a link to the DD Site ID Request form are posted in an Information Bulletin at the following link: https://www.dhs.state.il.us/page.aspx?item=118890 The DD Site ID Request does not contain any information that requires encryption. The completed form can be emailed to Maria.Prewitt@Illinois.gov.
Thank you for all you do!