Provider Notice Issued 04/08/2020

Date:    April 8, 2020
 
To:       Enrolled Home Health Agencies and Home Nursing Agencies
 
Re:      MFTD Waiver Rate Increase for Hourly In-Home Shift Nursing for Participants 21 Years of Age or Older
 
 
This notice informs providers of a rate increase for hourly in-home shift nursing for participants 21 years of age or older enrolled in the Home and Community Based Services Waiver for Medically Fragile Technology Dependent (MFTD) persons.
 

Effective with dates of service beginning February 19, 2020, the Department’s maximum allowable rates for in-home shift nursing for the Medically Fragile Technology Dependent Waiver participants 21 years of age and older have increased as follows:

  • Registered nurse services increased to $45.00.  
  • Licensed practical nurse services increased to $37.50.
  • Certified Nurse’s Aide services increased to $25.00.
These services are exempt from the 2.7% SMART Act rate reduction.
 
In-home respite nursing rates have not increased. The current rates remain in effect and are as follows:
  • Registered nurse services – standard rate $28.75; enhanced rate $35.03  
  • Licensed practical nurse services – standard rate $24.78; enhanced rate $31.14
  • Certified Nurse’s Aide services $20.00
The enhanced rates apply when:
    • The child is a resident of Cook County or collar counties.
    • The child is 24-hour ventilator dependent.
    • The child’s condition has deteriorated (i.e., child now requires additional ventilator assistance or has experienced a steady decline of overall health status).
    • The nurse staffing the case is required to travel in excess of 50 miles one-way.
    • The child is total parenteral nutrition dependent. In these cases, the rate increase applies to RN services only.
The enhanced rates are not automatically given in these instances but are approved on an individual case basis.
 
Out of home respite rates have not increased. The current rate of $35.03 remains in effect. 
 
Nursing training rates have not increased. The current rates remain in effect and a
re as follows:
  • Registered nurse services $28.75 and $35.03  
  • Licensed practical nurse services $24.78 and $31.14

Actual payment for covered services is based on the lesser of the provider’s charge or the maximum allowable rate established by the Department. The final amount payable by the Department would exclude applicable private insurance liability.  
 
Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565.
 
 
Kelly Cunningham
Interim Medicaid Administrator

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