HomeMy WebLinkAboutEI-104 Payer of Last Resort1
FRANKLIN/FULTON COUNTY
MENTAL HEALTH/INTELLECTUAL & DEVELOPMENTAL
DISABILITIES/EARLY INTERVENTION
425 Franklin Farm Lane
Chambersburg, PA 17202
(717) 264-5387
MH/IDD/EI PROCEDURE STATEMENT
PROCEDURE SUBJECT: Payer of Last Resort
PROCEDURE NUMBER: EI-104
Effective Date: April 26, 2010
Date Revised: October 23, 2018
References:
- Chapter 4426, Early Intervention Services – sections 4226.13 and 4226.14
- Announcement: EI-13 #02 Pennsylvania System of Payment
INTRODUCTION:
In accordance with ACT 212 and IDEA, Early Intervention services are provided at no cost to
families. The Department of Human Services receives money from the State and Federal
governments for Early Intervention services (tax dollars, Medical Assistance, Infant, Toddlers, &
Families Waiver). This money is in turn allocated to the MH/IDD/EI office which provides local
match dollars. The Franklin/Fulton Early Intervention Program utilizes a variety of sources to
fund programs for eligible children. The Office of Child Development and Early Learning
(OCDEL), the Office of Medical Assistance Programs (OMAP) and Franklin/Fulton Early
Intervention Program agree that Early Intervention Services are not usually covered by a Third
Party Insurance (TPI). This policy outlines the funding streams and clarifies when one funding
stream will be accessed versus another, utilizing MH/IDD/EI funding as the payer of last resort.
Services on the Individual Family Support Plan (IFSP) may not be denied or delayed because
another public or private funding source, including Medicaid, is unavailable.
PROCESS:
Service Coordinator (SC) will explain at the initial visit how Early Intervention is funded. SCs
will also inquire into insurance coverage for the child in order to identify the appropriate funding
stream that may be used should the child be determined eligible for services. SCs will inform
families about Medical Assistance and encourage them to apply so as to make available to
families potential benefits (e.g. community services). SCs will remind families that services are
to be provided at no cost to the family. SCs will review funding sources at IFSP meetings.
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Service Coordinators assist the family in identifying all potential funding. It is MH/IDD/EI
policy to identify and exhaust all other public and private sources of funding. Early Intervention
is the payer of last resort. SC discusses all possible sources of funding with the child’s parent and
documents those sources in the child’s file. The child’s Individualized Family Service Plan
(IFSP) provides written documentation about how each specific EI service is funded. The
provider will receive an authorization indicating the type of funding.
Parents are not required to enroll in Pennsylvania’s Medical Assistance Program, but the
supportive benefits received when doing so will be clearly explained to the family. If a family
enrolls in Medical Assistance (MA), the Early Intervention system can bill Medical Assistance
for Early Intervention services. Service Coordinators will assist families in this process if
requested.
Although private insurance is considered a potential funding source for EI services under
Chapter 4226.13, Pennsylvania insurance companies do not consider EI services as a covered
service under their health insurance policies.
For children who are covered by both third party insurance and Medical Assistance, Service
Coordinators shall inform families that if the IFSP team determines that a therapy service would
best suit their needs, the therapy service will be billed to Medical Assistance with third party
denial. The Service Coordinator would have the family sign a form stating they do not wish for
their private insurance to be billed and consent for services to be billed to Medical Assistance.
Service Coordinators will include in their documentation and all discussions relative to funding,
including conversations regarding insurance, Medical Assistance, and Infant, Toddlers, &
Families Waiver.