06/30/2022
Hello Everyone:
As you know, the legislature added funds to the EarlySteps budget to increase the reimbursement rates for EarlySteps services. There are several steps that are required within LDH to make the changes to the rates and to change FSC billing from unit-based to a flat monthly rate also part of the changes. These steps are undergoing a review and approval process now. Here is what we know so far:
1. We have to change the rates through the state’s rulemaking process. This means that the rates and billing changes will not be effective on July 1 as everyone hoped. You can bill at the higher rate beginning in July, but you won’t be paid at the higher rate until the changes are in effect when the final rules are published. Billing at the higher rate early means you will be paid at the current rate but reimbursed for the difference if claims are recycled back to an earlier date just in case that is allowed; however this is not currently expected. If you bill at the current rate, you will be paid at the current rate. We will let you know when the notice will be published in the Louisiana Register for your review and public comment as well the effective date of the rate changes.
2. The rates will include a 30% increase across the board for all services, both those paid for by Medicaid and those paid by the Central Finance Office. The exact rates are still being set, but estimates are:
--Therapies paid at $82.35/hour will increase to $107.06/hour
--Special Instruction will increase from $59.80/hour to $77.74/hour
--Eligibility Evaluations will increase from $196/event to $254.80/event
--FSC will increase from approximately $121.26/month (billing in units) to $169/month flat rate.
--The exact rates for all services will be posted to the CFO website when they are finalized, but you can calculate the approximate rate by multiplying the 30% increase for any service in the current rate schedule(s). You can review the current CFO rate schedule at: http://www.eikids.com/la/matrix/help/LAServicesandRates_08012018.pdf
3. FSC agencies must continue to bill in 15’ units until the change to flat rate goes into effect. We will communicate frequently about the process to make this change as it is finalized, because this change is effected by the way FSC prior authorizations are issued. In the past, a similar change required the cancelling and re-issuing of FSC authorizations by the SPOEs. More details about this will follow as they are worked out.
Now that a preliminary plan is in place, we will send out regular updates as decisions and timelines are established.
Special thanks to a hardworking group of providers and agency directors that supported this advocacy effort on behalf of everyone!
If you have questions please contact your regional coordinator, however, these are the up-to-date details for now.
Thank you, EarlySteps
