Temporary Changes for In-Home Services, Community Benefits, and Nursing Facility Level of Care Determinations

March 27, 2020

The information below is current as of the date of publication; however, Blue Cross and Blue Shield of New Mexico (BCBSNM) anticipates that guidance and directives will change as this health emergency evolves. BCBSNM encourages providers to check for changes to the Letter of Direction Learn more about third-party links on the New Mexico Human Services Department (HSD) website daily.

On March 18, 2020, HSD issued Letter of Direction (LOD) #30 – COVID-19 Guidance for Centennial Care 2.0 MCOs Learn more about third-party links. This LOD provides guidance and directives for Managed Care Organizations (MCO) for the modification of servicers and program standards related to the national public health emergency associated with 2019 Novel Coronavirus (COVID-19) outbreak.

HSD has issued additional COVID-19 guidance Learn more about third-party links for Centennial Care in-home service and community benefit providers.

HSD is temporarily waiving the requirement for Centennial Home Visiting (CHV) program providers to perform in-home visits. Instead, Nurse Family Partnership and Parents as Teachers home visitors will follow telehealth guidance in accordance with their curriculum standards, including the use of videoconferencing, if possible. Any activities that require an in-person visit with CHV clients will be deferred through the termination of the emergency declaration.

In-home community-based services, including Personal Care Services (PCS), Respite, Support Broker, and Home Health Aide services, must implement their emergency disaster plan. The agency disaster plans must include actions for in-person visits with members who have a confirmed diagnosis of COVID-19, and back-up plans for providing care when the member’s caregiver has been diagnosed with COVID-19.

HSD is suspending the in-home supervisory visit requirements for all in-home care service. Telephonic supervisory visits must be used instead of in-home supervisory visits. In-home community-based service providers, PCS providers, and PCS agencies should follow the guidance provided by the Centers for Disease Control and Prevention (CDC) on Implementing Home Care of People Not Requiring Hospitalization for COVID-19 Learn more about third-party links and Preventing the Spread of Coronavirus Disease 2019 in Homes and Residential Communities Learn more about third-party links.

MCOs are required to work collaboratively to develop mutually agreed upon protocols to reduce the administrative burden for providers.

HSD will be suspending Nursing Facility Level of Care (NFLOC) redeterminations for impacted members through the termination of the emergency declaration. HSD is not changing the timeframes for completing initial NFLOC determinations; however, the in-person visit requirement is being waived and shall be replaced with a telephonic assessment.

BCBSNM is temporarily waiving the requirement to have clients sign off on their plan of care. This exception is not contained within the LOD and other MCOs may not have similar exceptions.

BCBSNM is temporarily changing rules to transportation and will now allow caregivers to transport their members to medical professionals and, if needed, drive-thru COVID-19 testing sites. This exception is only in place through the duration of the emergency and is not mandated. Agencies that have a current prohibition against caregivers transporting clients do not need to provide transport. Agencies must continue to ensure that caregivers providing transportation meet the minimum requirements delineated in the HSD Managed Care Policy Manual including validation of mandated vehicle insurance.

BCBSNM will not allocate additional PCS hours for transportation. Caregivers may seek mileage reimbursement from Logisticare. Please refer to page 58 of the Blue Cross Community Centennial Member Handbook for more detailed information. Caregivers may call LogistiCare at 1-866-913-4342.

This exception is not contained within the LOD and other MCOs may not have similar exceptions.

References: https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-home-care.html Learn more about third-party linkshttps://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-prevent-spread.html Learn more about third-party linkshttps://www.bcbsnm.com/pdf/benefits/cc_member_handbook_nm.pdf