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- Waivers
What are Waivers?
Medicaid waivers are a way for Medicaid resources to be used to support people in their communities instead of in institutions.
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CCC Plus
(Formerly EDCD waiver) Here you’ll find assistance on how and where to apply for the CCC Plus waiverA Virginia Medicaid waiver program that provides services to elders and people with physical disabilities in the community (as opposed to in a nursing home) to prevent the premature institutionalization of these groups. Services available via this waiver include assistance with the Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs), such as bathing, grooming, dressing, light housecleaning, preparation of meals, and monitoring of medications. More, the criterion needed for approval, and what to do after approval is received.
CL/FIS
These waivers provide access to comprehensive services and supports to individuals living with developmental and/or intellectual disabilitiesA term used to describe a person with below-average cognitive ability, apparent before age 18, characterized by an IQ score at or below 70 and difficulties with adaptive behaviors. More. Community Service Boards (CSBsIn Virginia, the Community Services Board (CSB) is the public agency within each city and county that plans, organizes and provides services for people of all ages who have mental illness, substance use disorders, and/or intellectual disability. More) throughout Virginia administrate these waivers which are waitlisted.
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EPSDT
A federally mandated benefit for Medicaid-eligible individuals under the age of 21, EPSDT provides services needed to identify, diagnose, and treat conditions based on certain federal guidelines. Individuals must qualify financially for Medicaid prior to accessing EPSDT.
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Consumer Direct Care Network (CDCN)
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Electronic Visit Verification (EVV)
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Managed Care Organization (MCO) Overview
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Aetna
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Public Partnerships (PPL)
Useful Links for PPL
Contacting PPL
Customer Service Hours: Monday – Friday: 8am – 8pm; Saturday: 9am – 1pm | EST
PPL Customer Service Phone: 1-833-549-5672
PPL Customer Service Email: pplVA@pcgus.com
PPL is theFiscal Agent(F/EA)for the following Managed Care Organizations (MCO) for those on a CCC Plus Waiver:
- Aetna
- Effective January 1, 2021:
- NEW members to CD servicesServices where the person using them is allowed to select, hire, fire, and train their particular caregiver(s). More have the choice of Fiscal Agents PPL or CDCN.
- Existing members already enrolled with either PPL or CDCN will remain with their respective Fiscal Agent.
- Please click here for a list of common questions and answers regarding this change.
- For additional questions or concerns, please email: aetnaconsumerdirection@aetna.com.
- Effective January 1, 2021:
- Anthem
- Sentara Health Plans
- United Healthcare
Current Payroll Schedules for PPLTo view the payroll schedule for PPL for the Central and Tidewater regions, please click
Role of the Fiscal Agent
The Fiscal Employer Agent performs payroll activities on behalf of the Employer of Record (EOR). This allows the person to use waiver funds to hire and pay attendants. The above mentioned MCOs contract with PPL to ensure that payment to the attendant is accurate based on approved service authorizations and timesheets that have been approved by the EOR. The Fiscal Employer Agentkeeps payment records and follows all tax rules on the EOR’s behalf. The EOR employs the attendant(s).
Checking Authorizations
- Log into theweb portal.
- If you don’t have an account, pleaseregister.
- When registering, select the following options from the drop down menus as shown.
- If you don’t have an account, pleaseregister.
- Don’t forget to manually log out of the portal once finished
Electronic Visit Verification (EVV)
The 21st Century Cures Act set new rules requiring an Electronic Visit Verification system to capture clock-in and clock-out times for Home and Community Based Services, including consumer-directed waiver services. Time4Care is PPL’s mobile application that attendants can use to record their time as they deliver care to people. The app will capture an attendant’s start time, end time, and location at the start and end of their shift. People can also use Time4Care to review and approve an attendant’s time.
PPL is here to make this federally mandated law simple and stress-free with an easy to use and convenient Time4Care mobile app. This mobile app is tailor-made for the consumer-directed community. Since Time4Care analyzes bothEVV rulesand program rules, people know immediately if there is an issue with their time entry, giving them more time to fix any issues before pay day.
Note: If you have clocked in using the EVV app, you must clock out using the EVV app.
Time4Care on the App Store
Time4Care on Google Play
Interactive Voice Response (IVR)
In order to utilize IVR, the EOR must register the person’s landline with the Fiscal Agent. The Attendant will be required to clock in and out from the landline that was registered with the Fiscal Agent.
Please contact PPL to discuss eligibility and request use of IVR using the contact information noted in the Contacting PPL section below.
Additional Forms
Signatory Authority
The EOR may choose to have someone help with their duties in the Virginia Consumer‐Directed Services Program. The EOR role will not change if a Signatory Authority is used. A family member or friend can be in this role. PPL cannot release information to anyone, unless they are listed on this form, due to Health Insurance Portability and Accountability Act (HIPAA) requirements. Only submit this form if you are choosing someone to help you with Employer duties. This person may sign timesheets only, they cannot sign tax or hiring packets.
- Authorized Representative Agreement/Signatory Authority Form Instructions
- Authorized Representative Agreement/Signatory Authority Form
Difficulty of Care
Live-In Attendant Tax Exemptions: In certain circ*mstances, exemptions can be made for services furnished by other family members living under the same roof as the person enrolled in the waiver receiving services. However, there must be objective written documentation completed by the Service FacilitatorA Medicaid-enrolled provider who supports eligible people, and sometimes their families, in properly using consumer-directed services. More as to why there are no other providers available to render the personal services.
- Application for Difficulty of Care Federal Income Tax Exclusion
- This form must be completed in order to certify the attendant’s live-in status.
- IRS: Certain Medicaid Waiver Payments may be Excluded from Income
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