Today's deep dives look at New Jersey's May 6, 2027 deadline for licensed behavior analysts in DDD-funded Behavioral Supports and at federal fraud charges against a South Portland, Maine, personal care agency over electronic visit records. Below are the day's other stories, each linked to its source.
Today's deep dives
New Jersey DDD: ABA license needed by May 6, 2027. A DDD bulletin says the temporary exemption that let unlicensed clinicians deliver behavior supports ends next May, and that BCBA certification alone will not be enough. We cover which tasks are affected, what DDD wants provider agencies to do now, and what it could mean for DSPs.
Maine: 6 charged in $600K MaineCare EVV fraud case. Prosecutors say staff at Community Home Health Care entered false visit records for one client's personal care; all six defendants have pleaded not guilty. We explain the charges, the defense response and what agencies and workers should take from it.
More news today
Indiana: waiver denial rate falls to 3.5% after reassessments. At its Oct. 27 quarterly meeting, Indiana's Family and Social Services Administration said the denial rate for home and community-based services waivers, which spiked to 6% earlier this year after a new assessment process rolled out, is now 3.5%. WTHR reports that the agency found some case managers had done assessments by phone, without a guardian or without reviewing medical history, and that about 500 people appealing denials were reassessed. Asked whether assessors were properly prepared, FSSA Secretary Mitch Roob said, "I don't believe the training was complete in every case." FSSA did not say how many denials were overturned. Read our Oct. 2 story on the end of the denial pause. Source: WTHR
Indiana: how HIP will decide who is "medically frail" under work rules. At the same meeting, officials laid out a three-tier process for exempting Healthy Indiana Plan expansion members from work requirements that start Jan. 1. A claims-analysis tool will flag members with listed diagnoses or with qualifying conditions plus related treatment, and members not flagged can be referred, with medical records, to a three-person state clinical team. A Sept. 30 test run estimated nearly 140,000 people would qualify through the first two tiers. Physical, intellectual or developmental disabilities are among the five federal categories, and exemptions last six months at a time. The Indiana Capital Chronicle reports determination letters should go out by late November or early December. Read our Sept. 18 story on CMS's frailty rules. Sources: Indiana Capital Chronicle, Indiana FSSA
North Carolina: DOJ finds state in substantial compliance with TCL settlement. NCDHHS says the U.S. Department of Justice has found it in substantial compliance with the Transitions to Community Living settlement, which helps adults with serious mental illness move from state psychiatric hospitals and adult care homes into community housing. The department calls TCL a pillar of its Olmstead Plan and will hold a public webinar on the program's next steps on Nov. 2 from 1 to 1:45 p.m. Eastern. Read our deep dive on DOJ's shifting Olmstead enforcement. Source: NCDHHS
Money Follows the Person and HCBS spousal protections expire in 2027. The National Health Law Program is urging Congress to make both permanent. Money Follows the Person gives states extra funding to help people move from institutions back home. The spousal impoverishment protections let the spouse of someone on HCBS keep a modest income and assets. A 2023 spending law extended both through Sept. 30, 2027, according to the Congressional Research Service. NHeLP says funding gaps between 2018 and 2020 led many states to pause their programs and cut transitions by half. Read our Sept. 17 story on MFP's 144,651 transitions. Sources: National Health Law Program, Congressional Research Service