Office for People With Developmental Disabilities

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Liability Notices

02/27/12

The following Liability Notices are to be used by service providers in accordance with the processes outlined in the Liability for Services Quick Reference Guide Appendix 1, and  Appendix 2.

In addition to the Liability Notices listed above, the documents listed below are available for provider use.  Please refer to the Liability for Services Quick Reference Guide, Appendix 1, and Appendix 2 for information about the use of each of these documents:

Please note that under the Liability for Services regulations, "preexisting services "and other than preexisting services are specifically defined; understanding this distinction is critical to understanding providers’ responsibilities.  The following are some additional considerations for providers:

  • Fee reductions/waivers are only available for “preexisting services” in very limited situations
  • Providers may begin providing “other than preexisting services” prior to an individual being qualified for Medicaid/HCBS Waiver, but are not required to.  If they choose to do so, they must assume responsibility for the cost of services until the individual is Medicaid/Waiver enrolled.  In certain limited situations, funding may be available at the sole discretion of the DDRO serving the provider’s geographic area.
  • Services recorded through the OPWDD web applications (SEMP, Respite, and covered OPTS services) must:
    •  be payable by Medicaid (requires Medicaid/Waiver enrollment), or
    • be specifically authorized for state payment (enrollment does not constitute authorization for state payment), or
    • be for individuals qualifying for the single service Limited Exception (refer to Liability for Services Quick Reference Guide, Appendix 1, and Appendix 2 for additional information about the Limited Exception).

If none of the above conditions are met, the provider MUST NOT use the web applications to record services for payment.  Please be aware that providers doing so will be subject to post-payment review and recoupment.

Questions related to the ability to bill for services covered by the Liability for Services regulations may be directed to Stephanie Belisle, Revenue Support Field Operations, [email protected], 315-339-3440.