Plan revision

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All plan revisions are based on assessed needs and do not reduce medically necessary services needed to insure the heath, safety and welfare on persons. Case managers are required to notify waiver recipients of all actions that affect their requested or planned Medical Assistance services and their appeals rights in a timely manner, at least 10 calendar days prior to the effective date of the action.

Changes to service plans may occur at any time parties agree. In the event of an appeal, services may continue until decisions are made about the appeal or until the parties involved reach an agreement.

This process, referred to as quality assurance, brings case managers full circle. Information provided throughout the module applies at this point and the cycle begins again:

• Plan development/revision
• Service authorization
• Plan implementation
• Plan monitoring
• Plan evaluation

By clicking on the audio button below, Melanie concludes this lesson with some advice for new and experienced case managers.

 

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