equal-access-payment-practices

Reason(s) for non-compliance: • The Lead Agency does not pay all provider types prospectively or alternatively does not demonstrate that it is not a generally-accepted practice for all provider types, as required by 98.45(m)(1). (Plan Question 4.4.1a). Please note the Lead Agency has an approved waiver for this requirement through August 1, 2026. • The Lead Agency does not pay license-exempt in-home providers based on enrollment or alternatively does not provide justification that this is impracticable or is not a generally-accepted practice, as required by 98.45(m)(2). (Plan Question 4.4.1b). Please note the Lead Agency has an approved waiver for this requirement through August 1, 2026. • The Lead Agency does not pay license-exempt in-home providers on a part-time or full- time basis or alternatively does not provide justification that this is not a generally- accepted practice, as required by 98.45(m)(3). (Plan Question 4.4.2a) Overall Target Completion Date: 08/01/2026 Action Step Number Action Step Description Target Completion Date 1 The lead agency has submitted a waiver with an expected completion date. 08/01/2026 2 The Department will request additional funding to support system modifications to support system modifications to support prospective payments, part-time and full-time payments and enrollment based payments for all provider types. 10/01/2025 3 Contract with a consultant to research other state methods for prospective payments, lead stakeholder engagement activities and formulate recommendations to the Department related to key aspects in regard to implementing prospective payments for providers. 09/01/2025 4 Utilize stakeholder recommendations to begin design recommendations for billing system changes. 12/31/2025 5 Acquire legislative authority to pay by part- time/full-time and enrollment vs attendance for license exempt providers. 08/01/2026 6 Provide training and resources to providers specific to prospective billing requirements. 07/31/2026 7 Complete system changes and implement prospective payments for all providers. 07/31/2026