This Hot Tip serves as a reminder that in order for an Independent Living Waiver (ILW) provider to be reimbursed for Financial Management Services (FMS), the provider must be enrolled as a MO HealthNet Consumer-Directed Services (CDS) provider and complete a MO HealthNet FMS addendum. MO HealthNet continues to see claims deny for ILW providers billing for FMS, as some providers do not have the required FMS addendum on their provider enrollment file. The FMS addendum form is available on the Missouri Medicaid Audit and Compliance (MMAC) web site at https://mmac.mo.gov/providers/provider-enrollment/home-and-community-based-services/provider-contracts-forms/ or by contacting Provider Enrollment at mmac.ihsconracts@dss.mo.gov.
FMS provides assistance to the participant with administrative assistance, payroll functions and other supportive services. The participant has decision-making authority over their services and takes direct responsibility to manage these services with the assistance of a Financial Management Services provider.
Each month providers shall not bill for FMS unless at least one unit of CDS Personal Care - ILW (T1019 U6) services has been delivered.
Reimbursement
- One unit equals one month
- Unit Cost equals $110.00
- Procedure Code T2040 U6
Please refer to the Provider Bulletin Addition of Financial Management Services in the Independent Living Waiver, dated May 2, 2014 for additional information regarding FMS and provider enrollment information.
Additionally, MO HealthNet would like to remind ILW providers that all State Plan CDS Personal Care (T1019 U2) must be utilized (exhausted) prior to billing for CDS Personal Care – ILW (T1019 U6) in the ILW program.