Update: Timesheet Two Signature Rule Image

The Department of Health Care Policy and Financing distributed the following information on Wednesday, September 30, 2015 regarding the CDASS regulation which requires both the client/AR and attendant signatures on timesheets. If you have questions regarding this information, please contact Consumer Direct Colorado at 844-381-4433 or via email to infoCDCO@consumerdirectonline.net

During the July, August and September 2015 Participant Directed Programs Policy Collaborative meetings the Department informed stakeholders of its intention to enforce CDASS regulation 8.510.6.A.9 effective October 1, 2015.

Regulation 8.510.6.A.9 states it is the client/AR’s responsibility to “review all attendant timesheets and statements for accuracy of time worked, completeness, and client/AR and attendant signatures. Timesheets shall reflect actual time spent providing CDASS services.”

Stakeholders requested a rule change be initiated to remove the requirement for a CDASS attendant signature on the timesheet. After reviewing the request and in consultation with its internal legal and program integrity departments, as well as the Medicaid Fraud Control Unit at the Office of the Attorney General, the Department will not approve this stakeholder request. To the extent this requirement has not been enforced despite the current rule the Department has directed the FMS vendors to ensure compliance. Eliminating the attendant signature requirement will place the Department outside of our federal requirements.

Under federal regulations, the Department is required to have safeguards in place to allow for the timely identification of budget issues that would require a corrective action to be taken. In addition, the Department is required to keep in place requirements that would help identify when a participant or their representative is failing to effectively manage their services or their budget. Requiring attendants to attest to the number of hours they have provided the client in a given time period is essential. It allows the Department to quickly identify when there is a disagreement between the attendant and the client concerning the hours worked. The Department can then intervene to offer additional training and other aids under the rules. The attendant signature is also a faster way to identify clients who may not be effectively managing their attendants or their budget. Again, steps short of debarment from participation should be available when these issues are discovered quickly. Eliminating the attendant signature will delay Department intervention.

Although it is the rare occurrence, CDASS attendants may need to be held accountable under the federal and state false claims acts for misrepresenting the actual care provided. By requiring that attendants attest to their time entries, fraud actions can be directed against the guilty attendants and not toward clients who may have made a simple mistake. Overall the requirement ensures that the Department is meeting its requirements to monitor fraud, waste, and abuse.

The implementation date of October 1, 2015 remains in place and will not be modified. FMS vendor Public Partnerships (PPL) has completed modifications to their electronic timesheet portal and has taken active measures to message their clients regarding this change to attendant timesheet completion with the implementation date of October 1, 2015. Clients active with PPL are encouraged to contact PPL to prepare for this upcoming change.

Rhyann Lubitz
Participant Directed Programs Specialist
Office of Community Living