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The purpose of this memorandum is to alert physicians who review and provide final authorization or denial of Medicaid Long Term Services and Supports (LTSS) Screenings of the availability of the training module specific for physicians.

Please note: None of the requirements in this memo shall be implemented during the COVID-19 emergency declaration period.  Once the period is over, additional guidance regarding this requirement will be provided.

All physicians (and those authorized to sign for a physician per the Code of Virginia, 54.1-2957.02 and 54.1-2952.2) who have not yet been certified for the  Medicaid LTSS Screening, and who are responsible for reviewing and final authorization or denial of the Medicaid LTSS screenings must complete the physicians’ training, Module 5. Physicians should allow approximately 30 minutes for the training including taking the quiz at the end of the module and reviewing the resource handout LTSS Key Knowledge Points for Physicians.  A certification number will be provided following successful completion. Physicians will be required to enter this code when approving screenings; otherwise, the screening will not be valid in the Medicaid information system and potentially jeopardize Medicaid payment for services the individual receives. Completion of the training is required every three years.

Specific information regarding registration and the web accessible link for the training is available on the DMAS website, located under “Long Term Care” in the “Screening for LTSS” tab.  The link for long-term care programs is: http://www.dmas.virginia.gov/#/ltss.

Background

The Code of Virginia in § 32.1-330 requires a LTSS screening of all Medicaid members or Medicaid eligible individuals applying for admission to a certified nursing facility, as defined in § 32.1-123, or enrollment in the Commonwealth Coordinated Care Plus Waiver or Program for All-inclusive Care for the Elderly (PACE).

Per Virginia regulation 12VAC30-60-310. Competency Training and Testing Requirements, beginning July 1, 2019, each individual conducting screenings and providing authorization for approval of Medicaid LTSS shall have completed required training and passed competency tests  achieving a score of at least 80%.  Authorizing screeners are individuals who sign and attest to the DMAS-96 Medicaid LTSS Authorization form, including nurses, social workers, and physicians.

Questions and inquiries regarding this bulletin should be directed to: ScreeningAssistance@dmas.virginia.gov.

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