Provider Alert! COVID-19 Guidance for FMSAs and CDS Employer Orientations

Date: June 27, 2022

Attention: FMSA providers

Effective Date: June 23, 2022

The content in this message will remain in effect through August 31, 2022, as announced by the Health and Human Services Commission. Effective February 1, 2022, FMSAs can permanently conduct new employer orientation virtually (i.e. audio-visual) in addition to allowing in-person orientations, based on member preference.

COVID-19 Utilization Management Procedure and TCHP provider alerts can be found here: http://www.thecheckup.org/provider-alerts/

Providers should monitor the Texas Children’s Health Plan (TCHP) Provider Portal regularly for alerts and updates associated to the COVID-19 event.  TCHP reserves the right to update and/or change this information without prior notice due to the evolving nature of the COVID-19 event.

Call to action: The Health and Human Services Commission (HHSC) has provided guidance regarding Financial Management Services Agency (FMSA) requirements for providing CDS employer orientations under the Consumer Directed Services (CDS) option.

How this impacts providers: In response to COVID-19, HHSC has provided guidance to Financial

Management Services Agencies (FMSAs) regarding orientation requirements in the Consumer Direct Services (CDS) option. The details are as follows:

• On November 18, 2021, HHSC published IL 2021-54 which informed FMSAs that CDS orientations virtually (using audio-visual platforms), or in-person, would become permanent effective
  February 1, 2022.
• The IL also clarified that effective February 1, 2022, audio-only CDS orientations are no longer permitted.
• FMSAs are not required to provide in-person orientation visits for all CDS employers whose initial orientation was conducted virtually or by telephone from March 20, 2020 through January 31, 2022.
• For all CDS employers whose initial orientation was conducted virtually or by telephone from March 20, 2020 through January 31, 2022, the FMSA must provide the CDS employer an in-person orientation if the CDS employer requests an in-person orientation.
• If a CDS employer elects to receive an in-person orientation to replace one that was previously performed virtually or telephonically, the FMSA and CDS employer must complete a new Form 1736, Documentation of Employer Orientation by Financial Management Services Agency, upon conclusion of the orientation.

TCHP service coordinators will work with CDS employers to ensure that back up service plans are in place.  As required by CDS rules in the Texas Administrative Code (TAC) and STAR Kids and STAR+PLUS handbooks. TCHP will collaborate with FMSA providers to assist if needed, with identifying members that do not have a service backup plan in place.

This information is provided per direction from HHSC Information Letter 20-08 and gives recommendations to CDS employers for preventing the spread of COVID-19.

Questions related to CDS Policy & Operations can be directed to the CDS Policy & Operations team at CDS@hhsc.state.tx.us

If you have any questions, please email Provider Network Management at: providerrelations@texaschildrens.org.

For access to all provider alerts, log into:
www.thecheckup.org or www.texaschildrenshealthplan.org/for-providers.