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Back  RFI # 1746: Waivers/Demonstration Projects

Formal vs. Informal Help Informal Formal

Submitter

Dora Lambert

Description

Hawaii Medicaid has a need to collect/identify specific waiver, demonstration projects and/or carve-out services so that the 278 prior authorization can be processed according to the business of the waiver/demo/carve-out. Where can these waiver/demo/carve-outs be reported in the 278 transaction?

The 837 has such a REF segment (REF*P4), but we are unable to locate a similar REF segment in the 278.

Submitter Assigned Keywords

Waivers/Demonstration Projects/Carve-Outs

Response

The 278 transaction allows for use of the Message segment at both the HLEV
(Event) and HLSS (Service) levels to relay data that cannot otherwise be sent using codified information in existing data elements. A future guide update will be considered to accommodate a REF segment to collect/identify specific waiver, demonstration projects and/or carve-out services.
Submission 2/5/2013
Status Date 5/3/2013
Status F - Final
Primary References
Document 005010X217
SectionTable 2
Set ID0007
Table2