Changes to Individuals with Disabilities Education Act Part C Program (BabyNet) Services

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As part of the ongoing effort to improve the quality and delivery of services for infants and toddlers with disabilities through the Individuals with Disabilities Education Act (IDEA) Part C program, commonly known as “BabyNet,” the South Carolina Department of Health and Human Services (SCDHHS) is aligning BabyNet with the Healthy Connections Medicaid program through a series of policy and technology initiatives. Throughout the alignment process, SCDHHS has received feedback and questions from families, providers, and stakeholders about changes they will experience. SCDHHS is issuing this consolidated informational bulletin to address common questions and issues based on this feedback. 

BabyNet and Healthy Connections Medicaid are both state-administered programs, and SCDHHS is undertaking this alignment initiative to improve service coordination for infants and toddlers with disabilities participating in one or both programs, as well as payment to providers serving these children.

Features of the initiative include:

  • Providing an online forum for secure electronic referrals from parents, providers, and other community stakeholders. The portal will be available on SCDHHS’ website.

  • Directly enrolling service coordinators with SCDHHS and providing for direct billing of service coordination services through the BabyNet Reporting & Intervention Data Gathering Electronic System (BRIDGES) case management system.

  • Blending Medicaid and BabyNet funds into Medicaid managed care organization (MCO) rates, to allow therapy providers (speech therapy, physical therapy, occupational therapy, audiology, applied behavior analysis, and vision) that serve a dually eligible Medicaid and IDEA Part C child to bill a single MCO.

Some aspects of the BabyNet program will not be affected by this initiative. They include:

  • Providers are still required to log all services proffered pursuant to an approved Individualized Family Service Plan (IFSP) into the BRIDGES system for both payment and federal reporting. Providers electing not to enter service notes into the system may be subject to sanction, up to and including exclusion from the BabyNet program.

  • BabyNet service coordination providers, transportation providers, translators, and interpreters are not required to credential with any Medicaid MCO. All such services will continue to be paid on a fee-for-service basis using BRIDGES as the system of record for billing.

  • All assistive technology provided pursuant to an IFSP that cannot be authorized or billed as durable medical equipment (DME) will be reimbursed through the BabyNet grant on a fee-for service basis.

Other aspects of the BabyNet program will be changed as a part of this initiative during calendar year 2019. They include:

  • As announced in March 2019 and consistent with trainings provided, effective July 1, 2019, those providing service coordination and special instruction/family training services should cease entering service logs for dates of service on or after July 1, 2019, into Therap and instead must enter service logs into the BRIDGES case management system.

  • SCDHHS provided a training webinar to service coordination providers on June 20, 2019, to provide more information on the changes, which is available on SCDHHS’ website. A recording of the webinar can be accessed by visiting the BabyNet website, selecting the “For Providers” link, and then the “Announcements” link from the drop-down navigation menu.

  • All providers serving BabyNet beneficiaries who are not currently enrolled with SCDHHS, except transportation providers, translators, and interpreters, must enroll with SCDHHS by Oct. 1, 2019, if they are not currently enrolled as a South Carolina Healthy Connections Medicaid provider. Providers are advised that it may take up to 30 days to complete Medicaid enrollment, so it is recommended they begin the enrollment process immediately. SCDHHS will notify providers of successful enrollment. To enroll with SCDHHS providers must:

  • Obtain a national provider identification (NPI) number and a taxonomy number.

  • Providerscan apply for an individual NPI number on the Centers for Medicare & Medicaid Services’ website.

  • Use the correct taxonomy code as listed in the provider guide.

  • Complete and submit the Medicaid provider enrollment applicationto SCDHHS.

  • If South Carolina Healthy Connections Medicaid providers are not participating in the BabyNet program and would like to, they should contact BabyNet provider enrollment at bnproviderenrollment@scdhhs.gov.

  • Therapy providers rendering services to beneficiaries dually enrolled in a Medicaid MCO and BabyNet must enroll with the appropriate MCO. Providers rendering services to beneficiaries enrolled in an MCO will no longer be reimbursed for services provided to the beneficiary if they have not enrolled with the appropriate MCO by Oct. 1, 2019.

  • MCO enrollment will allow BabyNet providers to submit claims to the MCO during the continuity of care period, which will occur from Oct. 1-Dec. 31, 2019. After the continuity of care period has concluded, providers will not be able to bill for services to an MCO unless they have also credentialed with the MCO.

  • MCO credentialing requires that a provider fully and accurately completes a credentialing application if the provider is serving a beneficiary enrolled in that MCO, unless the provider is already credentialed with the MCO. It is important to note that credentialing in an MCO is effective on the date the application is approved and is not retroactive to the application date. Providers serving MCO beneficiaries must be credentialed with the appropriate MCO before Jan. 1, 2020. Providers who are not currently credentialed with South Carolina Healthy Connections Medicaid MCOs are strongly encouraged to contact MCOs regarding inclusion in their provider network as soon as possibleas it may take up to 60 days to complete MCO credentialing. Providers can contact MCOs through contact information included at the end of this bulletin.

Beginning Oct. 1, 2019, service coordinators must identify all BabyNet beneficiaries who are enrolled in an MCO and receiving services from a non-credentialed provider and begin transitioning beneficiaries to MCO-credentialed providers. Providers, except those noted above, electing to still provide services to MCO-enrolled beneficiaries outside of an MCO will no longer be reimbursed by South Carolina Healthy Connections Medicaid for their services for dates of service on or after Jan. 1, 2020.

A link to the BabyNet policy and procedure guide can be found here on SCDHHS’ website.

To assist providers with this transition and help address common questions, SCDHHS will host a series of webinars and continue to provide additional training and written guidance throughout the remainder of calendar year 2019. Webinars currently scheduled for July 2019 include:

Entering High Quality Service Logs

SCDHHS is offering a webinar entitled “Entering High Quality Service Logs” from 11 a.m.-noon on Friday, July 12, 2019. This webinar will focus on the common errors and issues that arise when entering service logs and provide information on support available to address those issues. Webinar participants will be able to submit questions during the presentation through the WebEx chat feature and SCDHHS will post the recording of the webinar to the BabyNet website for general access. To participate in the webinar, please follow the instructions below.

WebEx:

Call-in Only:

  • (415) 655-0001

  • Access Code: 749 408 142

July Bulletin Changes

SCDHHS is offering a webinar entitled “MCOs and Other Related Requirements for BabyNet Providers” from noon-1 p.m. on Wednesday, July 17, 2019. This webinar will focus on changes announced in this bulletin. Webinar participants will be able to submit questions during the presentation through the WebEx chat feature and SCDHHS will post the recording of the webinar to the BabyNet website for general access. To participate in the webinar, please follow the instructions below. 

WebEx:

Call-in Only:

  • (415) 655-0001

  • Access code: 742 839 848

MCO Contact Information

If you have questions regarding MCO enrollment or credentialing, please contact the appropriate managed care plan. If you have other questions, please contact the BabyNet BRIDGES Transition Team at the Provider Service Center at (888) 289-0709 and select option “1,” then option “6.” You can also email the BRIDGES Integration team at BRIDGES@scdhhs.gov.

Thank you for your continued support of the Healthy Connections Medicaid and IDEA Part C BabyNet programs.

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