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The New Jersey Division of Developmental Disabilities is shifting from a contract-based system of service reimbursement to a Medicaid-based, fee-for-service (FFS) reimbursement system.

To receive regular updates please subscribe to our e-news bulletin, Division Update, by sending an email to DDD.Communications@dhs.state.nj.us with "Division Update Subscribe" in the subject line.

Questions? Contact the Fee-for-Service Help Desk: 
DDD.FeeForService@dhs.state.nj.us



Supports Program to Launch in July - Invitation Extended to New Providers!

With the anticipated launch of the Supports Program and implementation of the Medicaid-based, Fee-for-Service System in July 2015, the Division is actively recruiting providers who have the interest and capacity to offer high quality services in the community for New Jersey adults (age 21+) with intellectual and developmental disabilities.

We invite current and prospective providers and other community partners to review and share our New Provider Welcome Packet, which includes a link to the webinar, Providing Services in the New Jersey Developmental Disabilities System: A Primer for New Providers.

To learn more or to begin the application process, please visit the Division's Provider Portal page.



Important Change in Combined Application Process

Contrary to previous guidance, the Division recently became aware that in order to apply to become an approved Medicaid/DDD provider and receive payment for claims submitted, service providers will need to obtain an NPI for each location from which services are delivered. This process goes quickly when applying through the National Plan and Provider Enumeration System (NPPES) website.

If you have already submitted your Combined Application to Become a Medicaid/DDD Approved Provider with just one NPI, you do not need to resubmit your application. Molina (Medicaid’s fiscal agent) will reach out to you to get the NPI for additional locations. Details on how and when Molina will contact providers who have already submitted the application are forthcoming.

If you have not yet submitted your Combined Application to Become a Medicaid/DDD Approved Provider, please proceed to the Provider Portal page and complete the application process.

We apologize for any inconvenience this change has created.



Provider Training Scheduled (REGISTRATION CLOSED)

Molina Medicaid Solutions, the State’s fiscal agent, will be hosting two provider sessions on electronic claiming as DDD billing transitions to Fee-for-Service from a payment voucher system:

Understanding the Molina Medicaid Electronic Billing Process
Tuesday, June 30  -OR-  Wednesday, July 15
10:00am – 12:00pm
DDD Central Office
Conference Room 199A/B
5 Commerce Way
Hamilton, NJ 08691

This training will cover what providers need to set up in order to bill electronically, the CMS 1500 claim form including use of procedure codes, and reasons why claims are rejected and how to resolve.

Pre-registration is required and is limited to two (2) representatives per agency. To register, please send your name, agency name, and preferred attendance date to Diane Flynn at Diane.Flynn@dhs.state.nj.us.

Email confirmation will be sent to all registered attendees.



Draft Supports Program Policies and Procedures Manual Released

New Fee-for-Service Rate Schedule: Quick Reference Guide Released



Registration Open for Live Webinars on DDD System Reform

To register, click on the title of the webinar you wish to attend, below. There are four different dates available for each of the two webinars.

When registering, please be sure to select the date you wish to attend from the dropdown menu/box at the top of the webinar registration page.

(A)
 DDD’s System Reform: Understanding What It Means for Someone Entering DDD Services

Target Audience:
 
Students with intellectual and developmental disabilities, their families, and school personnel

Dates and Times Available:
• Monday, July 13, 2015 – 2:00 PM to 4:30 PM

(B) DDD’s System Reform: Understanding What It Means for Someone Who Is Currently Receiving DDD Services

Target Audience:
Adults with intellectual and developmental disabilities who have already been receiving DDD-funded services, their families, and service providers

Dates and Times Available:
• Saturday, August 15, 2015 – 9:30 AM to 12:00 PM


Accessing Services in the Fee-for-Service System

To access Division-funded services in the Medicaid-based, fee-for-service system, individuals must be enrolled on one of two Medicaid waivers: 

(1) Supports Program 
     -OR-
(2) Community Care Waiver (CCW)

To learn about the services available through these Medicaid waivers, please review the Supports Program service definitions, limitations and qualifications that are included in the draft Supports Program Policies and Procedures Manual, and the draft Community Care Waiver Service Definitions and Qualifications.



Become a Provider of Services in the Fee-for-Service System

To become a provide of Division-funded services in the new Medicaid-based, fee-for-service system, an agency or individual must complete the Combined Application to Become a Medicaid/DDD Approved Provider.

The Combined Application and additional information for prospective providers can be accessed through the Provider Portal.


 
 
Fee-for-Service Information / Resources

Request for Tier Assignment Form
Supports Program Policies and Procedures Manual
Community Care Waiver Service Definitions and Qualifications (Draft)
Fee-for-Service Rate Schedule: Quick Reference Guide
Fee-for-Service Rate Schedule: Detailed Report
2015 Graduates Aging Out of the School System Timeline
Fee-for-Service Implementation Timeline Part II: January - July, 2015
Support Coordination Ramp-Up Timeline
 
Related Links

Provider Portal (Combined Application to Become a Medicaid/DDD Approved Provider available here)
Support Coordination
Supports Program
Community Care Waiver (CCW)
Medicaid Eligibility and DDD
Day Habilitation Certification for Providers

Fee-for-Service Frequently Asked Questions (FAQs)

Day Habilitation


 
 
Fee-for-Service Tools / Forms

Support Coordination

Support Coordination Agency Selection Form
List of Division-Approved Support Coordination Agencies
Selecting a Support Coordination Agency: Guide for Families (The Boggs Center)
Selecting a Support Coordination Agency: Guide for People with Disabilities (The Boggs Center)

Service Planning
Individualized Service Plan (ISP)
Person Centered Planning Tool (PCPT)


 
 
Fee-for-Service Webinars / Slide Presentations

•Providing Services in the New Jersey Developmental Disabilities System: A Primer for New Providers
(Webinar / Slides)

•Becoming an Approved Provider
(Webinar / Slides)
 
•DDD's System Reform: Understanding What It Means for Someone Currently Receiving DDD Services
(Webinar / Slides)

•DDD's System Reform: Understanding What It Means for Someone Entering DDD Services
(Webinar / Slides)   

•Completing the NJ Comprehensive Assessment Tool (NJ CAT) 
(Webinar / Slides)    

•Implementing the Rate Structure: Tiering in the Fee-for-Service System (Webinar / Slides)

•Implementing the Rate Structure: Tiers for Residential and Day Habilitation (Webinar / Slides

•How Is Case Management for DDD Services Changing? An Overview for Families of the Support Coordination Model in the New Fee-for-Service System (Webinar / Slides / Q&A for Support Coordination Webinar)

•Understanding the New Fee-for-Service System: An Overview for Individuals and Families 
(Webinar / Slides)

•Understanding DDD System Reforms: An Overview for Emerging Leaders in the Provider Community
(Slides)

•Update for DDD Providers on Fee-for-Service Rate Utilization 
(Webinar / Slides)



For information about the comprehensive rate-setting study commissioned by the Division, please visit the Fee-for-Service Rate-Setting web page.

 
 
 
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