Provider Notice issued 09/17/13

Bed Reserve Coverage for ICF/DD Residents 21 Years of Age and Older Reimbursement for Developmental Disability Aide, Basic Child Care Aide and Habilitation Aide Training

This Notice informs ICF/DDs that, effective July 22, 2013, therapeutic bed reserves for ICF/DD residents 21 years of age and older are payable and, effective September 1, 2013, reimbursement for Aide training will no longer be billed and reimbursed separately but will be added to the per diem reimbursement.

Payment of therapeutic bed reserves for those 21 years of age and older ended effective July 1, 2012, and has been reinstated beginning with bed reserves days from July 22, 2013 forward.

Payment for therapeutic bed reserve will be made for the first ten days of a therapeutic bed reserve within a state fiscal year (July 1 through June 30) to be payable at 100% of a facility's Medicaid per diem. Any days in excess of ten per state fiscal year will be payable at 75% of the facility's per diem.

Payment of hospitalization bed reserves for those 21 years of age and older has not been reinstated. The ID/DD Community Care Act requires the ICF/DD to hold a bed for up to ten days when a resident is temporarily absent due to a hospitalization. A resident has the right to appeal any notice of discharge and request a hearing with the Department of Public Health within ten days of receiving the written notice of discharge.

All bed reserves must still be reported electronically using the MEDI system or through a REV vendor. If any provider feels that a bed reserve was coded incorrectly they have the ability to change the coding by submitting a corrective transaction through the MEDI system or REV vendor systems, within the time limits for payment consideration.

When providers enter their bed reserve electronically through the MEDI system or REV vendor they should enter a therapeutic bed reserve as a type 20 and the system will automatically convert it to a type 22 (payable at 100% of the facility's per diem) or a type 24 (payable at 75% of the facility's per diem).

A provider that needs assistance completing an electronic transaction may contact the Bureau of Long Term Care Billing Unit at 217-524-7237.

Effective September 1, 2013, revisions to 89 Il Adm Code Section 140.539 reflect that Developmental Disability Aides, Basic Child Care Aides, and Habilitation Aides will no longer have their training costs billed and paid separately. These costs will be added to the rate paid to the ICF/DD. The ICF/DD rate will be increased by $1.06 per day for residential rate and $3.64 per month for developmental training rates.

All other questions should be directed to the Department of Human Services Division of Developmental Disabilities at 217-782-0636.

Theresa A. Eagleson, Administrator

Division of Medical Programs