Good afternoon,

Thank you for the opportunity to respond to the CANS Lifetime Assessment Manual.

5.1.1A What happens if the CANS Lifetime is completed by another company and (a) we are unable to get the results (b) there is provider disagreement (c) what is the reimbursement for additional coordination of care (d)Why do children need CANS updates every three months while adults only need them every six months? What is the clinical justification for this. 

How much does it cost for providers to be certified and re-certified in CANS.

Will there be assistance for this as most staff will be required to be credentialed.

What is the reimbursement rate for the initial CANS?  It sounds like the subsequent periodic CANS will only be reimbursed through units/sessions however units are limited. Having this requirement every 3 months is an abundance of admin duties considering the other duties required by CPST (care coordination, crisis services, diagnostic assessment, Quarterly/ISP, etc.). This is especially true when we have to do a reassessment and full CANS in addition to a quarterly CANS.

Will quarterly updates change the client's LON? If so, will authorized services and units increase or decrease automatically, or will another assessment be required? The MCO continue to make approvals difficult, are inconsistent and accessing staff for appeals, expedited appeals and peer to peer reviews is cumbersome. How will that be streamlined to not create further admin duties?

If a client is improving because services are working, how will DMAS ensure those improvements don't result in services being reduced too soon?

What if services recommended by the recommended level of care are unavailable in areas?