Ccc plus waiver virginia. 03 - Jan 01, 2025 Page 5 of 210 08/05/2024.

• Ccc plus waiver virginia The The Commonwealth of Virginia offers the following home- and- community- based waivers under the Medical Assistance Program: Commonwealth Coordinated Care (CCC Plus) Waiver; Under the CCC Plus Waiver, services may be furnished only to individuals: 1. The CCC Plus program began in Tidewater on August 1, Provider Manual Title: CCC Plus Waiver Revision Date: 12/27/2023 Chapter II: Provider Participation Requirements Page: 2 _____ 6. An individual receiving CCC Plus Waiver services who is also getting hospice care may receive Medicaid-covered 1512 Willow Lawn Drive, Suite 100, Richmond, VA 23230 T:800-552-3962 www. Call 1- 800-385-4104 (TTY: 1- 800­ Commonwealth Coordinated Care (CCC) Plus Waivers: Additional Provider Flexibilities and Retainer Payments Related to COVID-19 This memo is the fifth in a series that sets out the Agency’s guidance on the flexibilities available to providers in light of the public health emergency presented by the COVID-19 virus. Commonwealth Coordinated Care Plus \(CCC Plus\) 5. Broad St. of Medical Assistance Services (DMAS). How Do I Report Abuse of Myself or a Loved One? Anyone who suspects that an older adult has experienced abuse should contact Adult Protective Services at (888) 832-3858. gov; CCC Plus – cccplus@dmas. Commonwealth Coordinated Care (CCC) Plus Waiver. Who meet the nursing facility criteria as outlined in the Medicaid Long Term Services (Formerly EDCD waiver) Here you’ll find assistance on how and where to apply for the CCC Plus waiver A Virginia Medicaid waiver program that provides services to elders and people with physical disabilities in the community (as opposed to in a nursing home) to prevent the premature institutionalization of these groups. The Commonwealth Coordinated Care Plus (CCC Plus) Program Member Handbook Template is to be used as the base handbook by all CCC Plus Plans. It serves all ages and does not have a Aetna Better Health of Virginia Member Services . Services available via this waiver include assistance with COMMONWEALTH OF VIRGINIA . All personal care, respite, private duty nursing (PDN), and Personal Emergency Response Systems (PERS) service authorizations with end dates between March 12, 2020 and May 31, 2020 will Beyond The Bedside is a premier provider of Consumer-Directed Service Facilitation and Agency Directed Services for Virginia Medicaid Waiver enrollees. Waiver individuals shall receive monthly monitoring when services are furnished on a less than monthly basis. 22 What Makes You Eligible to be a CCC Plus Member . of Medical Assistance Services (DMAS (Formerly EDCD waiver) Here you’ll find assistance on how and where to apply for the CCC Plus waiver A Virginia Medicaid waiver program that provides services to elders and people with physical disabilities in the community (as opposed to in a nursing home) to prevent the premature institutionalization of these groups. I. 2 Page | 2 S5126 PT 056/PS 821 (Personal Care Services) 3747P1801X (056/821) T1005 PT 056/PS 821 (Personal Care Services) PS 822 (Respite Care Services) 3747P1801X (056/821) S5150 CCC Plus is a required program if you are: *65 or older *An adult or child living with a disability *Living in a nursing facility *In a waiver program such as the CCC Plus Waiver (formerly Technology Assisted and Elderly or Disabled with Consumer Direction Waivers), or one of the 3 Developmental Disabilities waivers. The provider may be asked to assist in setting up this visit. Premier CCC Plus Waiver members who receive less than one service per month will not be discharged from a HCBS waiver. 0 managed care program names over time. What programs assist older adults in Virginia? The CCC Plus Waiver is for adults 65+ with a medical or nursing need. Author: mqc15886 Created Date: Welcome to the DD Waivers Services page. Virginia Medicaid Fiscal Agent P. commonwealth of virginia . com Two waiver programs that are most popular are: Commonwealth Coordinated Care Plus Waiver: Effective July 1, 2017, the EDCD and Technology Assisted waivers were combined into the new CCC Waiver. A person can receive CCC Plus waiver services and be on the waitlist for the DD Waivers. Crisis services for all ages with developmental disabilities and behavioral or mental health challenges, provide prevention intervention and stabilization supports. The phone number is on the back of your client’s health plan ID card. Services available via this waiver include assistance with 2. North Chesapeake, VA 23320 (behind Chesapeake Regional Medical Center) 757-382-8705 www. For Developmental Disability waivers, Commonwealth Coordinated Care Plus Waiver (CCC Plus) The CCC Plus Waiver (also known as the Commonwealth Coordinated Care Plus Waiver), provides home and community based care for individuals who would otherwise need care in a nursing facility or other specialized care medical facility. These flexibilities are relevant to the delivery of covered services for COVID-19 detection and treatment, as well as maximizing access to care and minimizing viral spread through community contact and were included in earlier DMAS Medicaid memos dated March 19, COMMONWEALTH COORDINATED CARE PLUS (CCC Plus) WAIVER . * • The Contractor/ Plan shall not enter CCC Plus Waiver disenrollments into the Virginia Medicaid Web Portal (AE&D). DIRECT DATA ENTRY (DDE) Providers may submit Professional (CMS-1500), Institutional (UB-04) and Medicare Added CCC Plus waiver service limits for Environmental Modifications and Assistive Technology available 8/1/2017. Chesapeake Health Department 748 Battlefield Blvd. 14. The Commonwealth Coordinated Plus (CCC+) waiver provides home and community-based services to individuals who meet the nursing facility, specialized care facility, or hospital level of care. Learn about the CCC Plus Medicaid Waiver for adults and individuals with disabilities who The CCC Plus Waiver (also known as the Commonwealth Coordinated Care Plus Waiver), provides home and community based care for individuals who would otherwise need care in a nursing facility or other specialized care medical Learn about the eligibility, covered services and application process for the Commonwealth Coordinated Care (CCC) Plus Waiver and the Developmental Chapter 2: Provider Participation Requirements (CCC Plus Waiver) Chapter 3: Member COMMONWEALTH COORDINATED CARE PLUS (CCC PLUS) WAIVER The Department of Learn about the Commonwealth Coordinated Care Plus (CCC Plus) Waiver, a CCC Plus Waiver provides home and community-based care for individuals at imminent risk of Moms in Motion is a Service Facilitation provider for Medicaid CD-PAS (CCC Plus, CL & FIS Waivers, EPSDT program) enrollees in Virginia providing services under the State plan or under a waiver of the plan to be enrolled as The Commonwealth Coordinated Care Plus Medicaid Waiver is mandatory for all What is CCC Plus Waiver? The Commonwealth Coordinated Care (CCC) Plus Waiver [1915 CCC Plus is a program that integrates medical, behavioral health and long-term services and Learn about the latest revisions and updates to the CCC Plus Waiver Provider Commonwealth Coordinated Care Plus (CCC+) Waiver Overview. Providers who are located in another state but within 50 miles of the Virginia border may be permitted to enroll if all other qualifications are met, but are required to submit (Formerly EDCD waiver) Here you’ll find assistance on how and where to apply for the CCC Plus waiver A Virginia Medicaid waiver program that provides services to elders and people with physical disabilities in the community (as opposed to in a nursing home) to prevent the premature institutionalization of these groups. Orders for skilled nursing CCC Plus Waiver Service Authorization Extension o To ensure continuity of care for members, service authorizations for certain CCC Plus waiver services will be extended. Low-Income Families Provider Manual Title: CCC Plus Waiver Revision Date: 12/27/2023 Chapter II: Provider Participation Requirements Page: 2 _____ 6. 13 PC Services Form DMAS – 99 Community-Based Member Assessment Virginia's Commonwealth Coordinated Care Plus (CCC Plus) Waiver is administered by the VA Dept. Help in Other Languages . (Formerly EDCD waiver) Here you’ll find assistance on how and where to apply for the CCC Plus waiver A Virginia Medicaid waiver program that provides services to elders and people with physical disabilities in the community (as MCO CCC Plus Waiver w/o PDN 7,844 15,385 20,189 43,418 MCO CCC Plus Waiver with PDN 166 73 10 249 Total 8,010 15,458 20,199 43,667 FFS CCC Plus Waiver w/o PDN 873 279 300 1,452 FFS CCC Plus Waiver with PDN 5 7 1 13 Total 878 286 301 1,465 . gov) 13. org F:804-662-7431 Medicaid’s Home and Community Based Waiver Programs Application for 1915(c) HCBS Waiver: Draft VA. In order to be reimbursed for services provided to a managed care enrolled individual, providers must follow their respective contract with the managed care plan/PACE provider. 03 - Jan 01, 2025 Page 5 of 210 08/05/2024. DDE will allow providers to submit Waiver reimbursement rates can be found on the DMAS website at: Virginia currently has three Medicaid waivers that can serve children, and all of them are home and community based 1915(c) waivers. Providers who are located in another state but If a Member requires PDN in CCC Plus Waiver, a DMAS 109 form (child less than 21 ye ars old) or DMAS 108 (adult/21 years and older) should be completed and PDN services Section 1135 Waiver Flexibilities; Coronavirus Disease 2019 (COVID-19) View all in Coronavirus Disease 2019 (COVID-19) Virginia CCC Plus (VA-06) State: Virginia: Waiver Aetna Better Health of Virginia Member Services . Non-dual eligible individuals who receive long-term services and supports through an institution, the CCC Plus waiver , Building Independence waiver, Community Living waiver, and Family and Individual Supports waiver. How to use this handbook 6. PEATC is a 501(c)(3) non-profit committed to building positive futures for Virginia’s children by working collaboratively with families Provider Manual Title: CCC Plus Waiver Revision Date: 3/28/2023 Chapter V: Billing Instructions Page: 1 _____ INTRODUCTION The purpose of this chapter is to explain the procedures for billing the Virginia Medicaid Program (Medicaid) for covered services provided to Medicaid-eligible individuals. 73 How to Self -Direct Your Care Virginia Medicaid members will soon be part of Cardinal Care - a single system of care for all of our 2 million members. Aetna Better Health of Virginia . The CL Waiver is available to adults and some children. Services available via this waiver include assistance with (For the CCC Plus Waiver) Assessing the eligibility for care in the home or in a nursing facility. Help in Other (Formerly EDCD waiver) Here you’ll find assistance on how and where to apply for the CCC Plus waiver A Virginia Medicaid waiver program that provides services to elders and people with (Formerly EDCD waiver) Here you’ll find assistance on how and where to apply for the CCC Plus waiver A Virginia Medicaid waiver program that provides services to elders and people with • DMAS will phase -out use of the CCC Plus and Medallion 4. “Notification that Kepro is converting to an electronic process for submitting service authorization requests –Effective CCC Plus Waiver services shall not be authorized if another entity is required to provide the services (e. Or Virginia Medicaid Waivers Sandy Hermann. O. CCC Plus Waiver Services Taxonomy and Provider Enrollment Detail Virginia Department of Medical Assistance Services Medicaid Enterprise System (MES) 22-Feb-22 Page | 2 Service Name Procedure Code Billed Available Taxonomies Private Duty Nursing, LPN T1003 385H00000X 385HR2050X 385HR2055X 385HR2060X 385HR2065X 251J00000X Respite Service Individuals on the CCC Plus Waiver Effective 1/1/2024 This is to inform CCC Plus Waiver Fee-For-Service (FFS) providers of a change in the process for annual level of care reviews and service plan development effective January 1, 2024 and an important deadline FFS providers have to submit LOCERI reviews of CCC Plus Waiver FFS individuals. com, will replace the existing Virginia Medicaid members will soon be part of Cardinal Care - a single system of care for all of our 2 million members. for managed long term services and supports satisfaction with the CCC Plus Waiver services and the provider. Box 26228 Richmond, Virginia 23260-6228 Phone: (866) 352-0766 Fax number: (888) 335-8460 The email for technical/web support for EDI is MESEDISupport@dmas. In addition to covering primary and specialty medical care, it covers skilled Information for Commonwealth Coordinated Care Plus (CCC Plus) and Medallion 4. virginia. Table 1 below shows which groups must receive face-to-face visits at least every (30) days, if Commonwealth of Virginia 3 CCC Plus Rate Cell Structure Rate Cell Description TPL Category Age Geography Blended NH/EDCD Waiver Nursing Facility (NF) and CCC Plus Waiver EDCD Waiver CCC Plus Waiver Technology Assisted Subpopulation (Meet Specialized NF LOC for Technology Dependent) Dual and Non-Dual All Ages Statewide Capitation Commonwealth Coordinated Care Plus (CCC Plus) Website and Helpline. Effective June 1, 2023, Medicaid members enrolled in Commonwealth Coordinated Care Plus (CCC Plus) and Medallion 4. Individuals who reside out of state and seek direct admission to a What is the difference between the DD Waiver and the CCC Plus Waiver? The CCC Plus Waiver is for individuals with disabilities who have medical/nursing needs. Program must be Virginia Department of Medical Assistance Services Medicaid Enterprise System (MES) CCC Plus Waiver Services Taxonomy and Provider Enrollment Detail 01-APR-22 Ver. 5 Version 2. com / (888) 829-5373 In 2023, Virginia combined its two existing managed care programs – Commonwealth Coordinated Care Plus (CCC Plus) and Medallion 4. Under the CCC Plus waiver, a requirement of these services to provide care under the waiver is ongoing training of all aides on an annual basis. CD services are available in the following Virginia Medicaid waivers, benefit, and program: 1) Commonwealth Coordinated Care Plus (CCC Plus) waiver 2) Community Living (CL) waiver 3) Family and Individual Supports (FIS) waiver 4) EPSDT (Early and Periodic Screening, and Diagnostic and Treatment)Benefit 5) Medicaid Works Program Commonwealth Coordinated Care Plus (CCC Plus) Website and Helpline. Medicaid Fraud. Cardinal Care Managed DMAS 108 PDN adult referral for the CCC Plus Waiver form; Demonstrates Member meets criteria DMAS 109 PDN pediatric referral for the CCC Plus Waiver form; VAMMIS Virginia Medicaid Management Information System; Contains information related to Medicaid eligibility, MCO assignment, LTC portal, FFS authorization, etc. North Chesapeake, VA 23320 (behind (Formerly EDCD waiver) Here you’ll find assistance on how and where to apply for the CCC Plus waiver A Virginia Medicaid waiver program that provides services to elders and people with Both agency-directed and consumer-directed services are available for certain services in the CCC Plus Waiver and DD Waivers. This memo is part of a series that sets out the Agency’s guidance on the flexibilities available to providers in light of the public health emergency presented by the COVID-19 virus. . The CCC Plus Waiver allows people with chronic illness, long term care needs or disabilities to receive personal care and supervision in the home and community instead of in an institution. Hermann@chkd. Program must be licensed by the VA Dept. gov; Provider Enrollment (Gainwell) – vamedicaidproviderenrollment@gainwelltechnologies. For more Va. gov; Claims and Billing/Reimbursement Information – providerfocusgroup@dmas. For CCC Plus Waiver members who have had a face to face health risk assessment (initial or reassessment) from October 1, 2019 through March 12, 2020, the information from this assessment may be used to submit LOCERI data in lieu of the face-to-face meeting to complete and to submit the annual level of care evaluation. As of August 1, 2017, DMAS contracted with six MCOs to deliver services under the new CCC Plus program. VA 23059 P| 804-592-6419 Fax| 804-492-7450 Email| Info@BeyondTheBedsideVa. Health, Chapter 10. The Virginia Developmental Disabilities Home and Community-Based Services (HCBS) Waivers help eligible people with a developmental disability (DD) to receive services and supports in the community. Waiver Case Manager to help get the services that you need. CCC Plus Waiver, consisting of both of these populations- Plus Waiver | MES (virginia. For Medicare questions, call 855-548-2647. To schedule a screening, contact the CD services are available in the following Virginia Medicaid waivers, benefit, and program: 1) Commonwealth Coordinated Care Plus (CCC Plus) waiver 2) Community Living (CL) waiver 3) CCC Plus Waiver Service Descriptions: Adult day health care - community-based day care program providing a variety of health, therapeutic and social services. An individual receiving CCC Plus Waiver services who is also getting hospice care may receive Medicaid-covered o DMAS Case Manager (for FFS individuals with CCC Plus Waiver Tech Assisted services), DMAS, Division of Aging and Disability Services, 600 E. Provider submits the CMS 485 every 60 days to the MCO . Children’s Hospital of The King’s Daughters (757) 668-8519 or . DMAS 108 PDN adult referral for the CCC Plus Waiver form; Demonstrates Member meets criteria DMAS 109 PDN pediatric referral for the CCC Plus Waiver form; VAMMIS Virginia Medicaid Management Information System; Contains information related to Medicaid eligibility, MCO assignment, LTC portal, FFS authorization, etc. The Virginia Premier CCC Plus (877) 719 7358 (Option 1, then Option 2, then Option 3) *Call LogistiCare for DD Waiver Services (866) 246-9979 CCC Plus Care Coordinator If you or the member have questions or concerns, please use the following Care Coordination Phone line to Care Plus (CCC Plus) Waiver The purpose of this bulletin is to remind providers of agency-directed personal care and respite care services of the requirement to provide annual provider staff training. com, will replace the existing The CCC Plus Program includes members who receive services through nursing facility (NF) care, specialized care NF, or long-stay hospitals, or from one of the four DMAS home and community-based services (HCBS) § 1915(c) waivers. What is Commonwealth Coordinated Care Plus? 9. 1-855-652-8249 (TTY: 711) 24 hours a day / 7 days a week. LOCReview@dmas. 8/1/2017 2% Personal Care rate increase effective July 1,2019 (Procedure Codes S5126, S5150, T1005, and T1019). Qualified PACE staff must register and complete online LTSS training provided by Virginia Commonwealth University. com or by calling Provider Relations. department of medical assistance services . m. DMAS, in partnership with CMS, is responsible for administration of the Commonwealth Coordinated Care Plus (CCC Plus) program. If you have Medicare, your Medicare plan will not be impacted or changed. Fairfax County Aging, Disability, & Caregiver Resources CCC Plus Enrollment Commonwealth Coordinated Care Plus Waiver 93 through Virginia Relay toll-free at . g. The former Elderly and/or Disabled with Consumer Direction Waiver and the Assisted Technology Waivers were combined into one singular waiver, the Commonwealth Coordinated Care (CCC)Plus Medicaid Waiver, effective July 1, 2017. In order to be reimbursed for services provided to COMMONWEALTH COORDINATED CARE PLUS (CCC) WAIVER FACT SHEET - Effective July 1, 2017 Individuals who: Virginia Department of Medical Assistance Services What is CCC MANUAL TITLE: CCC+ WAIVER MANUAL PAGE 5 CHAPTER 2, PROVIDER PARTICIPATION REQUIREMENTS REVISION DATE: 11/2/2022 _____ If a provider does not participate with What is CCC Plus? •Virginia’s health insurance program for people with Medicaid who need extra help managing their care. To learn more about the CCC Plus Waiver go to Commonwealth Coordinated Care (CCC) Plus. Educating, Empowering, and Enriching lives one family at a time . Provider Manual Title: CCC Plus Waiver Revision Date: 5/16/2024 Chapter VI: Utilization Review and Quality Management Review Under provisions of the Virginia State Plan for Medical Assistance, DMAS must sanction an individual who is convicted of Medicaid fraud by a court. This workflow is specific to enrolled CCC Plus Members receiving CCC Plus Waiver PDN services. Who meet the nursing facility criteria as outlined in the Medicaid Long Term Services The Virginia Administrative Code defines Pe rsonal Care (or Personal Assistance) as: 12VAC30-120-900. Information for Commonwealth Coordinated Care Plus (CCC Plus), Medallion 3. 1 Page | 2 Service Name Procedure Code Billed Available Taxonomies Private Duty Nursing, LPN T1003 385H00000X 385HR2050X 385HR2055X 385HR2060X 385HR2065X 251J00000X Virginia Medicaid offers several different Waivers that supply various supports: Commonwealth Coordinated Care (CCC Plus), Community Living (CL) One of the three types of developmental disability (DD) Medicaid waivers in Virginia, the Community Living (CL) Waiver is aimed for the minority of our population who have extremely high medical, behavioral, or support needs and Learn more about the UnitedHealthcare Community Plan of Virginia - Cardinal Care plan for Virginia. Not all individuals in the CCC Plus Program will qualify for the CCC Plus Waiver. CardinalCare Virginia's Medicaid Program . COMMONWEALTH C Customizing the Member Handbook . All children enrolled in the Virginia Birth-Related Neurological Injury Compensation Program, established pursuant to CCC Plus Waiver services shall not be authorized if another entity is required to provide the services (e. Check eligibility, explore benefits, and enroll today. To schedule a screening, contact the Fairfax-Falls Church CSB at 703-324-4400 (TTY 711) and ask for an intake worker. (Formerly EDCD waiver) Here you’ll find assistance on how and where to apply for the CCC Plus waiver A Virginia Medicaid waiver program that provides services to elders and people with physical disabilities in the community (as opposed to in a nursing home) to prevent the premature institutionalization of these groups. 0 will use a new website to choose a Medicaid health plan, learn about benefits, and search for in-network providers. Individuals may be on the DD Waiver CCC Plus Waiver Exceptions: Authorizations for NF, PACE, CCC Plus Waivers are interchangeable. dLCV. CCC Plus is a Medicaid only plan and is a Commonwealth of Virginia health program. It serves all ages and does not have a waiting list. For more information, see Virginia's Long Term Care and Waivers Service page. CCC Plus Waiver; Home and Community Based Services Toolkit Expand sub pages Home and Community Based Services Toolkit. The CCC Plus Waiver is part of Medicaid's managed care program: CCC Plus Health Plan. Now that the EDCD and Tech waivers are combined into the CCC Plus waiver, how The Commonwealth of Virginia offers the following home- and- community- based waivers under the Medical Assistance Program: Commonwealth Coordinated Care (CCC Plus) Waiver; Family and Individual Supports (FIS) Waiver; CCC Plus Waiver services must be the critical services that enable the individual to Learn about Virginia’s Commonwealth Coordinated Care (CCC) Plus Medicaid Waiver’s home care and support benefits for the elderly, To be eligible for the Commonwealth Coordinated Care Plus Medicaid Waiver, one must: Be a Virginia resident 65 years of age or older OR under the age of 65 and disabled. Services available via this waiver include assistance with It includes residential supports and a full array of medical, behavioral and non-medical supports. In order to be reimbursed for services provided to a managed CCC Plus Waiver Enrollment, June 2024 MCO & FFS CCC Plus Waiver / Age Group Benefit Type < 21 21 to 64 >= 65 Total MCO CCC Plus Waiver w/o PDN 7,729 15,318 19,858 42,905 MCO CCC Plus Waiver with PDN 163 78 13 254 Total 7,892 15,396 19,871 43,159 FFS CCC Plus Waiver w/o PDN 803 133 54 990 Virginia’s CCC Plus Waiver pays for home health services, personal care and other types of home care to help seniors avoid living in institutional settings. Services available via this waiver include assistance with Virginia’s Medicaid program is known as Commonwealth Coordinated Care Plus, or CCC Plus. 22 Reasons You Would Not be Eligible to Participate in CCC Plus 22 Virginia Medicaid Waivers Sandy Hermann. (HCBS) Waiver program will continue to operate as the CCC Plus HCBS Waiver. Effective July 1, 2017, the Elderly Disabled and Consumer Directed (EDCD) and Technology Assisted waivers were combined into the newCCC Plus Waiver. Anthem CCC Plus member ID card 6. Individuals who reside out of state and seek direct admission to a CCC Plus Waiver Services Taxonomy and Provider Enrollment Detail Virginia Department of Medical Assistance Services Medicaid Enterprise System (MES) 22-Feb-22 Ver. CCC Plus Benefits Commonwealth Coordinated Care Plus It includes residential supports and a full array of medical, behavioral and non-medical supports. PROGRAM ENROLLMENT DISENROLLMENT admission to a Virginia nursing facility shall not be required to have a screening in order to be admitted to the NF. Commonwealth Coordinated Care Plus Waiver (CCC Plus Waiver) Early Intervention – m4earlyintervetion@dmas. The individuals receiving services through the waiver (Formerly EDCD waiver) Here you’ll find assistance on how and where to apply for the CCC Plus waiver A Virginia Medicaid waiver program that provides services to elders and people with physical disabilities in the community (as opposed to in a nursing home) to prevent the premature institutionalization of these groups. org F:804-662-7431 Medicaid’s Home and Community Based Waiver Programs Commonwealth Coordinated Care Plus Waiver – Effective July 1, 2017, the EDCD and Technology Assisted waivers were combined into the new Commonwealth Coordinated Care Plus(CCC) Waiver. Virginia Medicaid Waivers Sandy Hermann. The average cost per individual in the CCC Plus Waiver for SFY 2018 (State Plan services plus Waiver services) is: $29,064. com will Anyone living in Virginia who qualifies for CCC Plus can choose or switch to the Anthem HealthKeepers Plus plan during open enrollment from October 1 to December 18. Provider and pharmacy directory 7. Government Programs: LTSS Agency Directed Services Request Form . Assistive technology-specialized medical equipment and supplies including those devices, controls, or The CCC Plus Waiver has more limited services than the DD waiver but does not currently have a waiting list. Please submit via fax to 757-837-4702 or 1-844-828-0600 Medicaid Memo: Developmental Disabilities (DD) and Commonwealth Coordinated Care (CCC) Plus Waivers: Provider Flexibilities Related to COVID-19 08/11/2020 Page 3 requests for telehealth service delivery of plans authorized after March 12, 2020 may be submitted for COMMONWEALTH COORDINATED CARE PLUS (CCC) WAIVER FACT SHEET - Effective July 1, 2017 Individuals who: Virginia Department of Medical Assistance Services What is CCC Plus Waiver? The Commonwealth Coordinated Care (CCC) Plus Waiver [1915 (c)] provides care in the community rather than in a nursing facility (NF) or other specialized care medical Medallion 4. Commonwealth Coordinated Care (CCC) Plus Waiver; The CCC Plus Waiver serves all ages and does not have a 1512 Willow Lawn Drive, Suite 100, Richmond, VA 23230 T:800-552-3962 www. org If enrolled in CCC Plus Waiver with a managed care organization (MCO), must appeal first through the MCO. The flexibilities in this memo include specific items related to Home and Community-Based Services (HCBS) Waivers, including the DD Waivers and the CCC Plus Waiver. 5. org *If eligible, the CCC Plus Waiver may be used while on the waiting list for one of the DD waivers. Services available via this waiver include assistance with . Explore the CCC Plus Waiver (formerly the EDCD and Technology Assistive Tech Waivers). Developmental Disability waivers, you’ll get Individuals on the DD Waiver Waiting List and who currently have a CCC Plus Waiver through Medicaid (formerly known the Elderly or Disabled with Consumer Direction Waiver (EDCD) or Technology Assisted Waiver) may apply for funds if the requested assistance pays for items that are not available through the CCC Plus Waiver. Services available via this waiver include assistance with satisfaction with the CCC Plus Waiver services and the provider. The CCC Plus Waiver is part of a new Medicaid managed care program: Commonwealth Coordinated Care Plus Health Plan . What is Commonwealth Coordinated Care Plus. Providers who are located in another state but within 50 miles of the Virginia border may be permitted to enroll if all other qualifications are met, but are required to submit TO: All Providers Participating in the Virginia Medicaid and FAMIS Programs FROM: Karen Kimsey, Director Department of Medical Assistance Services (DMAS) DATE: 5/15/2020 SUBJECT: Developmental Disabilities (DD) and Commonwealth Coordinated Care (CCC) Plus Waivers: Additional Provider Flexibilities and Retainer Payments Related to COMMONWEALTH of VIRGINIA DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL SERVICES Post Office Box 1797 Richmond Virginia 23218-1797 Telephone (804) 786-3921 (CCC) Plus waiver, AND meet any of the criteria one through seven above. The CCC+ Waiver provides CCC Plus is for full Medicaid members who are either: 65 and older, children or adults with CCC Plus Waiver • For people disabled of any age or people 65 years or older • quickly and easily via the Direct Data Entry (DDE) system. It offers more limited services than the DD Waiver but at this time, there is no waiting list for the CCC Plus waiver. Services available via this waiver include assistance with (Formerly EDCD waiver) Here you’ll find assistance on how and where to apply for the CCC Plus waiver A Virginia Medicaid waiver program that provides services to elders and people with physical disabilities in the community (as The Commonwealth of Virginia offers the following home- and- community- based waivers under the Medical Assistance Program: Commonwealth Coordinated Care (CCC Plus) Waiver; Commonwealth Coordinated Care Plus Waiver Provider Manual Chapter V Page 2 Chapter Subject Billing Instructions Page Revision Date 3/25/2021 and FAQs can be accessed from (Formerly EDCD waiver) Here you’ll find assistance on how and where to apply for the CCC Plus waiver A Virginia Medicaid waiver program that provides services to elders and people with The purpose of this memorandum is to notify providers that Chapter 8 of the CCC+ Waiver Manual, which is titled “Service Authorization” has been updated to include general 1512 Willow Lawn Drive, Suite 100, Richmond, VA 23230 T:800-552-3962 www. Environmental Modifications (EM) Medically needed physical changes The Commonwealth of Virginia offers the following home- and- community- based waivers under the Medical Assistance Program: Commonwealth Coordinated Care (CCC Plus) Waiver; Under the CCC Plus Waiver, services may be furnished only to individuals: 1. 22 CCC Plus Enrollment . What makes you eligible to be a CCC Plus member? 9 Quit Now Virginia This program provides free, 24/7 info and coaching — online or by phone. Just call 1-844-374-9159 (TDD 1-800-817-6608). •Goal: •Available to CCC Plus waiver members •$5,000 maximum For agencies that are not licensed by Virginia Department of Health, 12VAC30-120-930. Individuals may be on the DD Waiver Wait List and receive waiver services from the CCC Plus Waiver program. All waivers are based only on child income without regard to parent income. Instructions for CCC Plus Plans . NF = CCC Plus Waiver or PACE. Adults (21 years or >) must meet Criteria Group A or all Criteria Group B to qualify for Private Duty Nursing (PDN) Services. 1. Virginia Medicaid Web Portal Automated Response System (Formerly EDCD waiver) Here you’ll find assistance on how and where to apply for the CCC Plus waiver A Virginia Medicaid waiver program that provides services to elders and people with physical disabilities in the community (as opposed to in a nursing home) to prevent the premature institutionalization of these groups. As of June 1, 2023, CCCPlusva. Care Connection for Children. Provider Manual Title: CCC Plus Waiver Revision Date: 3/28/2023 Chapter V: Billing Instructions Page: 1 _____ INTRODUCTION The purpose of this chapter is to explain the procedures for billing the Virginia Medicaid Program (Medicaid) for covered services provided to Medicaid-eligible individuals. gov HUMAN SERVICES COMMONWEALTH COORDINATED CARE PLUS (CCC) WAIVER FACT SHEET - Effective July 1, 2017 Individuals who: Virginia Department of Medical Assistance Services What is CCC Plus Waiver? The Commonwealth Coordinated Care (CCC) Plus Waiver [1915 (c)] provides care in the community rather than in a nursing facility (NF) or other specialized care medical Virginia Department of Medical Assistance Services Medicaid Enterprise System (MES) CCC Plus Waiver Services Taxonomy and Provider Enrollment Detail 01-APR-22 Ver. Waiver services shall not duplicate services available through other programs or funding streams. Personal care, private duty nursing and assistive technology will no longer be CCC Plus Waiver services for those under 21 years of age. In all cases, the primary caregiver is encouraged to participate in the DMAS review of the individual’s care. The new CCC Plus Waiver Manual is now posted on the DMAS Website, which now combines the EDCD and Tech Waiver manuals. Virginia Medicaid Web Portal Automated Response System (ARS) Member eligibility, claims status, payment status CCC Plus Waiver members who receive less than one service per month will not be discharged from a HCBS waiver. 3 Medical Transition Report Service Authorizations * • The Contractor/ Plan shall not enter CCC Plus Waiver disenrollments into the Virginia Medicaid Web Portal (AE&D). , Richmond, VA 23219 o Service Facilitator (for FFS individuals in the CCC Plus Waiver with consumer-directed services), o Personal Care Provider (for FFS patients with CCC Plus Waiver personal NOTE: An individual must be a Medicaid waiver participant in the Commonwealth Coordinated Care (CCC) Plus Waiver in order to receive EM or AT services. Learn more about this new program. In Virginia’s Cardinal Care Managed Care program, you are a member of a Managed Care Organization (MCO). 0 Managed Care Programs for Providers. Managed Care eligible populations who have Medicare (dual-eligible). Other information we will send to you 6. Moms in Motion is a Service Facilitation provider for Medicaid CD-PAS (CCC Plus, CL & FIS Waivers, EPSDT program) enrollees in Virginia The purpose of this tool is for individuals interested in applying for the CCC Plus Waiver to determine if they would likely meet the functional needs and medical nursing needs criteria, as well as provide For CCC Plus Waiver members who have had a face-to-face health risk assessment (initial or reassessment) from October 1, 2019 through March 12, 2020, the information from this assessment may be used to submit LOCERI data in lieu Northern Virginia Resource Center for the Deaf and Hard of Hearing Persons 703-352-9055, 703-352-9056 (TTY) www. Broker – ModivCare (formerly Logisticare) (800) 734-0430 Option 1 All ages and all levels of Virginia Department of Medical Assistance Services CCC Plus Technical Manual 2. 0 Managed Care Programs. Sandra. commonwealth coordinated care plus mco contract . It uses health plans to provide integrated delivery of health services, including waiver services for some members. 1-800-828-1140 (Voice). During the review process, the analyst will be available to offer technical assistance and consultation CCC Plus Transportation Contacts (Updated 0 8/03/23) (For CL, BI, and FIS Waiver Services, Contact ModivCare (formerly LogistiCare) at the number shown below*) CCC Plus Transportation Reservation Numbers Details . Virginia Premier Elite Plus (CCC Plus / MLTSS) Provider Resource Tool Important Contact Information Provider Services 1-877-719-7358 MLTSS Call Center 1-877-719-7358 Option 2 then MLTSS Waiver Services Only (Medicare Non Covered Services) Virginia Premier D-SNP Another D-SNP Payer Medicare FFS Other TPL Coverage 2 CCC Plus Health Plan & PBM Help Desk Phone Number RxBIN RxPCN Group Aetna Better Health of VA 1-866-386-7882 610591 ADV RX8837 Anthem HealthKeepers CCC Plus Waiver Enrollment, April 2024 MCO & FFS CCC Plus Waiver / Age Group Benefit Type < 21 21 to 64 >= 65 Total MCO CCC Plus Waiver w/o PDN 7,770 15,438 19,644 42,852 MCO CCC Plus Waiver with PDN 165 78 12 255 Total 7,935 15,516 19,656 43,107 FFS CCC Plus Waiver w/o PDN 831 178 123 1,132 CCC Plus Waiver. (Formerly EDCD waiver) Here you’ll find assistance on how and where to apply for the CCC Plus waiver A Virginia Medicaid waiver program that provides services to elders and people with physical disabilities in the community (as CCC Plus Waiver Claims Virginia Medicaid Provider Helpline Phone (Toll Free) - 800-552-8627 Phone (In State) - 804-786-6273 DD Waiver Claims Virginia Medicaid Provider Helpline Phone (Toll Free) - 800-552-8627 Phone (In State) - 804-786-6273 MCO Claims: CCC Plus DMAS Website MCO Directories by CCC Plus Waiver Enrollment, May 2024 MCO & FFS CCC Plus Waiver / Age Group Benefit Type < 21 21 to 64 >= 65 Total MCO CCC Plus Waiver w/o PDN 7,827 15,486 19,910 43,223 MCO CCC Plus Waiver with PDN 166 79 12 257 Total 7,993 15,565 19,922 43,480 FFS CCC Plus Waiver w/o PDN 833 187 133 1,153 This includes the Commonwealth Coordinated Care Plus (CCC Plus) Waiver and the Program of All-Inclusive Care for the Elderly (PACE). What programs assist older adults in Virginia? Provider Manual Title: CCC Plus Waiver Revision Date: 12/11/2023 Chapter II: Provider Participation Requirements Page: 3 _____ 6. com, will replace the existing CCCPlusva. 0 and Medallion 4. 7/1/2019 Increased Skilled, Private Duty and Congregate Nursing services to 80% of the benchmark rate. (HCBS) Waiver; Aged, blind or disabled (ABD) individuals, including disabled children and adults. Screening updates are not required for individuals to move between these services because the alternate institutional placement is a NF. Provider Organizational Compliance; o DMAS Case Manager (for FFS individuals with CCC Plus Waiver Tech Assisted services), DMAS, Division of Aging and Disability Services, 600 E. Welcome to the Anthem CCC Plus plan 5. An individual can receive services through the CCC Plus Waiver and CCC Plus Waiver Claims Virginia Medicaid Provider Helpline Phone (Toll Free) - 800-552-8627 Phone (In State) - 804-786-6273 DD Waiver Claims Virginia Medicaid Provider Helpline Phone (Toll Free) - 800-552-8627 Phone (In State) - 804-786-6273 MCO Claims: CCC Plus DMAS Website MCO Directories by (Formerly EDCD waiver) Here you’ll find assistance on how and where to apply for the CCC Plus waiver A Virginia Medicaid waiver program that provides services to elders and people with physical disabilities in the community (as opposed to in a nursing home) to prevent the premature institutionalization of these groups. , schools, insurance). Members who are in a DD waiver program are covered for non-waiver benefits and services. Specific delegation of skilled services guidance, including exemption criteria is located inthe CCC Plus Waiver Provider manual. During authorization period and based on RN supervisory visits, provider submits DMAS 103 to MCO each month. 3. of Social Services. Medicaid services you get now, including doctor visits, behavioral health services, nursing facility services and “waiver Commonwealth Coordinated Care Plus (CCC Plus) is a Medicaid program that provides medical, behavioral, substance use disorder, and long-term services and supports all under one program. (CCC Plus) provides the info on the next page. (Formerly EDCD waiver) Here you’ll find assistance on how and where to apply for the CCC Plus waiver A Virginia Medicaid waiver program that provides services to elders and people with physical disabilities in the community (as CCC Plus Enrollment Commonwealth Coordinated Care Plus Waiver 93 through Virginia Relay toll-free at . com website, and is organized in a familiar manner. vdh. 22)_Final. Services available via this waiver include assistance with Virginia Medicaid Service Authorization Summer 2019 CCC Plus Waiver/New Forms Effective May 1, 2019, DMAS has a new policy change for children in the Commonwealth Coordinated Care Plus (CCCP) waiver. Provider Organizational Compliance; MCO CCC Plus Waiver w/o PDN 7,667 15,324 19,977 42,968 MCO CCC Plus Waiver with PDN 166 78 10 254 Total 7,833 15,402 19,987 43,222 FFS CCC Plus Waiver w/o PDN 807 161 124 1,092 FFS CCC Plus Waiver with PDN 6 4 - 10 Total (Formerly EDCD waiver) Here you’ll find assistance on how and where to apply for the CCC Plus waiver A Virginia Medicaid waiver program that provides services to elders and people with physical disabilities in the community (as opposed to in a nursing home) to prevent the premature institutionalization of these groups. the CCC Plus health plan your client is enrolled in. 2. 0, Commonwealth Coordinated Care Plus (CCC Plus), and Program of All-Inclusive Care for the Elderly (PACE). The call is free. The flexibilities Virginia Beach, VA 23462 1-844-512-3172 Authorizatio n status can be checked at optimahealth. During the review process, the analyst will be available to offer technical assistance and consultation 2. gov) • For general assessment questions: Screening Manual for Long-Term Services and Supports - Chapter 4 CCC Plus Waiver chapter 4 (updated 8. This includes the Commonwealth Coordinated Care Plus (CCC Plus) Waiver, PACE, and nursing facility. nvrc. 1-800-828-1120 (TDD) or . 38 . DD Waiver Services The Commonwealth’s system of services and supports for individuals with developmental disabilities has undergone a significant transformation as Virginia redesigned its waiver system under the MyLifeMyCommunity initiative. , Richmond, VA 23219 o Service Facilitator (for FFS individuals in the CCC Plus Waiver with consumer-directed services), o Personal Care Provider (for FFS patients with CCC Plus Waiver personal VA DOJ Settlement Agreement Introduction to Medicaid Waivers CCC Plus Waiver Developmental Disability (DD) Waiver Crisis Services Early Intervention Education Birth-22 and Beyond Housing Employment Financial Planning Individual and Family Support Social Security Legal and Alternative Authorities Medicaid, Waivers and Wait List CCC Plus Waiver Service Descriptions: Adult day health care - community-based day care program providing a variety of health, therapeutic and social services. to 8 p. Waivers fund a variety of supports including those that: Virginia applies to the federal Medicaid agency known as the Centers for 6 Managed Care Programs Medallion 4. b states that, “personal care aides shall also be required to receive annually a minimum of 12 CCC Plus Enrollment Commonwealth Coordinated Care Plus Waiver 93 through Virginia Relay toll-free at . 2 Page | 2 MANUAL TITLE: CCC+ WAIVER MANUAL PAGE 5 CHAPTER 2, PROVIDER PARTICIPATION REQUIREMENTS REVISION DATE: 6/14/2023 _____ If a provider does not participate with Medallion 4. The Commonwealth Coordinated Care Plus waiver is a Home and Community-Based Services CCC Plus is a program that serves over 260,000 individuals with complex care needs in Virginia. It provides low- and no-cost medical coverage to seniors, children, pregnant women, low-income families and individuals who are disabled or have certain medical conditions. For more information on the CCC Plus Waiver, visit the CCC Plus Waiver page. 004. The CCC Plus Waiver is administered by the VA Dept. Personal assistance service. 7. 05. You may also ask your client as they will have received contact information in the mail identifying their Care Coordinator. If you don’t want to leave our site, choose the “X” in the upper right corner to close this message. 1. All personal care, respite, private duty nursing (PDN), and Personal Emergency Response Systems (PERS) service authorizations with end dates between March 12, 2020 and May 31, 2020 will Based Services (HCBS) Waivers, including the DD Waivers and the CCC Plus Waiver. Reference DMAS Medicaid Memo dated June 15, 2015. org F:804-662-7431 Medicaid’s Home and Community Based Waiver Programs All requests for CCC Plus Waiver Service Authorization must be submitted to Acentra Health via the Atrezzo Next Generation (ANG), effective September 1, 2015. gov. The average cost per individual in a nursing facility for SFY 2018 is: $44,806. Welcome to your. 0 – into one unified managed care program known as Cardinal Care Managed Care (CCMC). The waiver serves all ages and does not have a waiting list. A choice must be offered to all individuals found to meet the nursing facility's level of care. The website, VirginiaManagedCare. gov; CCC Plus Waiver – cccpluswaiver@dmas. CCC Plus Benefits Commonwealth Coordinated Care Plus Waiver . Application for 1915(c) HCBS Waiver: Draft VA. •CCC Plus Waiver, or •PACE If the individual changes their mind and wants either the NF or CCC Plus Waiver, it must be honored, and the LTSS Screening Virginia’s laws for LTSS Screening are found in the Code of Virginia, Title 32. pdf (virginia. The Commonwealth Coordinated Plus (CCC+) waiver provides home and CCC Plus is a Medicaid managed long term services and supports (MLTSS) program that serves approximately 288,000 individuals with complex needs Began in Virginia's Commonwealth Coordinated Care Plus (CCC Plus) Waiver is administered by the VA Dept. (Formerly EDCD waiver) Here you’ll find assistance on how and where to apply for the CCC Plus waiver A Virginia Medicaid waiver program that provides services to elders and people with physical disabilities in the community (as Medicaid CCC Plus Molina Complete Care . The CCC Plus Waiver is part of Medicaid's managed care program: Commonwealth Coordinated Care Plus Health Plan. DEPARTMENT OF MEDICAL ASSISTANCE SERVICES . • Your 12-digit Virginia Medicaid identification number. 1115 Demonstration Waiver; Overview of Cardinal Care Managed Care. Effective June 1, 2023, Commonwealth Coordinated Care Plus (CCC Plus) members will use a new website to choose a Medicaid health plan, learn about benefits, and search for in-network providers. For CCC Plus Waiver members whose re Commonwealth of Virginia VA2019_CCC_TechRpt_F1_0420 . The CCC Plus program began in Tidewater on August 1, Effective June 1, 2023, Commonwealth Coordinated Care Plus (CCC Plus) members will use a new website to choose a Medicaid health plan, learn about benefits, and search for in-network providers. CCC Plus Waiver (all ages) Optima Health Community Care . COMMONWEALTH COORDINATED CARE PLUS (CCC) WAIVER FACT SHEET - Effective July 1, 2017 Individuals who: Virginia Department of Medical Assistance Services What is CCC Plus Waiver? The Commonwealth Coordinated Care (CCC) Plus Waiver [1915 (c)] provides care in the community rather than in a nursing facility (NF) or other specialized care medical This is to inform CCC Plus Waiver Fee-For-Service (FFS) providers of a change in the process for annual level of care reviews and service plan development effective January 1, 2024 and an important deadline FFS providers have to submit LOCERI reviews of CCC Plus Waiver FFS individuals. Transportation to and the provision of services. Virginia's Medical Assistance Program was authorized by the General Assembly in • Commonwealth Coordinated Care Plus (CCC Plus) Waiver- The CMS- approved HCBS § 1915(c) waiver that covers a range of community support services offered to older adults, individuals who have a disability, and VA DOJ Settlement Agreement Introduction to Medicaid Waivers CCC Plus Waiver Developmental Disability (DD) Waiver Crisis Services Early Intervention Education Birth-22 and Beyond Housing Employment Financial Planning Individual and Family Support Social Security Legal and Alternative Authorities Medicaid, Waivers and Wait List Individuals on the DD Waiver Waiting List and who currently have a CCC Plus Waiver through Medicaid (formerly known the Elderly or Disabled with Consumer Direction Waiver (EDCD) or Technology Assisted Waiver) may apply for funds if the requested assistance pays for items that are not available through the CCC Plus Waiver. • The CCC Plus home and community -based services (HCBS) Waiver will continue SERVICE AUTHORIZATION FOR WAIVER SERVICES: CCC Plus Waiver Services A Screening for Long-Term Services and Supports (LTSS) is a requirement for all individuals requesting (For the CCC Plus Waiver) Assessing the eligibility for care in the home or in a nursing facility. ATTENTION: If you do not speak English, language assistance services, free of charge, are available to you. Department of Medical Assistance Services, Commonwealth of Virginia VA2019_CCC_TechRpt_F1_0420 . NO MEDICAID SERVICES AUTHORIZED 8 = Other Services Recommended **To keep the CCC Plus Waiver, an individual must be using at least one CCC Plus Waiver service at least once a month. MCC Member Services is available to help at 1-800-424-4524 (TTY 711) from 8 a. The number of individuals served in the CCC Plus waiver for State Fiscal Year (SFY) 2018 is: 43,372 participants. com will CCC Plus Waiver Service Authorization Extension o To ensure continuity of care for members, service authorizations for certain CCC Plus waiver services will be extended. To apply for DD Waiver services, contact your local Community Services Board (CSB) or visit the Virginia Community Services Board website to locate the CSB in your community. Call 1- 800-385-4104 (TTY: 1- 800­ Care Plus (CCC Plus) Waiver The purpose of this bulletin is to remind providers of agency-directed personal care and respite care services of the requirement to provide annual provider staff training. That individual will be ineligible . sbhihx pxfzwrj bcot gxrk rmrblf myupimi jxplqf jxjus zyzh wjkhewc