Welcome to Maine's ASO

State of Maine Department of Health and Human Services (DHHS) Administrative Services Organization (ASO)

Announcements

9/28/2022 - Atrezzo Provider Announcement

Atrezzo Upgrade 

On Monday, November 7th, Kepro will be upgrading their web-based platform to Atrezzo Next Generation. The Atrezzo Next Generation (ANG) platform is an improved interface with enhanced security features such as Multi-Factor Authentication (MFA). ANG brings the Maine Administrative Services Organization (ASO) an even more flexible, intuitive, and highly automated system that streamlines the utilization review and reporting processes for clients and providers. ANG fulfills all components of the scope of services defined in the Maine ASO UM program, as it offers the modularity and flexibility needed to evolve with the ever-changing healthcare technology landscape. Our flexibility comes from ANG’s best-in-class platform, custom-built by Kepro, which can be rapidly configured and tailored to meet ASO’s unique program needs.

Training Plan and Resources

A full functioning array of resources including training manuals, informational materials, webinars, and training videos are utilized. Training materials will be placed on the Maine ASO client website, located at http://www.qualitycareforme.com/. Training session will be a recorded demonstration in a live webinar to allow discussion and answer questions. There will be several modules for the providers to attend based on user role permissions. Providers will receive links to register for the session date and time that works best for their availability.

For a list of our upcoming trainings, please visit https://me.kepro.com/providers/atrezzo/

9/2/2022 - Attention Section 92, Section 13, and Section 17 Providers: Passthrough process now required if organizations jointly serve an Opioid Health Home (OHH) Member

Please click here to view the Office of MaineCare Listserv announcement.

6/17/2022 - Attention Referents and Providers of MaineCare Benefits Manual Section 97, Appendix D Children's Residential Care Facility (CRCF) Services: Aftercare Support Services

Attention Referents of MaineCare Benefits Manual Section 97, Appendix D Children’s Residential Care Facility Services.  Currently, Referents are expected to review the CRCF Information Sheet with families prior to a referral to CRCF services.  As part of the application for CRCF services, the Acknowledgement Form must also be signed by the family and youth with the appropriate service checked off. 

Effective immediately, Referents must also review the Aftercare Support Services Information Sheet with families and youth as part of the referral for CRCF services.  Both CRCF and CRCF Aftercare Support Services must be checked on the  Acknowledgement Form.

Attention Providers of MaineCare Benefits Manual Section 97, Appendix D Children’s Residential Care Facility Services, the Aftercare Support Services Information Sheet should be reviewed with youth and families upon admission to the CRCF. Additional information about Aftercare Support Services can be located in the Aftercare Support Services FAQs.

For Referents and Providers of MaineCare Benefits Manual Section 97, Appendix D Children’s Residential Care Facility Services, the Aftercare Support Services Webinar is now available. OCFS recommends all referents review the webinar prior to making referrals for CRCF services.

5/24/2022 - Attention Providers of Adult Behavioral Health Services: Updated Critical Incident Definitions 

The Office of Behavioral Health (OBH), in coordination with Kepro, have updated the definitions of a Critical Incident to better clarify when it must to be reported through the Kepro Atrezzo system.  

Level One (1) Critical Incident

A Level One (1) Critical Incident are those that result in death or serious injury and/or significantly jeopardize clients, public safety, or program integrity. Such incidents involving clients must be reported to OBH regardless of the location of the incident. A client’s death is always reported as a Level 1, regardless of whether the death was attended or not, and regardless of the cause of death.

Examples of Level 1 Critical Incidents include:

  • Suicide, homicide, other causes of death
  • Clinical or medication error resulting in emergency medical care for client 
  • Lost, missing client or client that left the facility Against Medical Advice (AMA) in a residential/Crisis Stabilization Unit (CSU) placement which would rise to the level of Silver Alert and/or who are under guardianship, in the Care and Custody of the Commissioner, and/or in violation of conditions of release/court order
  • Alleged abuse: physical/sexual, emotional abuse, neglect, and financial exploitation of client by a staff
  • Alleged serious crime (e.g., arson, assault, hostage) by client with extreme risk of harm to client, staff, or public
  • Other serious events (fire, flood, motor vehicle accident in company vehicle with clients that requires medical attention for staff and/or client(s)
  • Natural disaster, building becomes uninhabitable, incidents that require client evacuation from the building
  • Medical outbreak   
Level Two (2) Critical Incident

A Level Two (2) Critical Incident are those where significant errors or undesirable events that compromise quality of care or client safety occur.

Examples of Level 2 Critical Incidents include:

  • Alleged abuse: physical/sexual, emotional abuse, neglect, and financial exploitation of client by someone other than a provider staff
  • Suicide attempt that requires medical intervention
  • Self-harm that requires medical intervention
  • Lost or missing client or client that left the facility AMA in facility (Private Non-Medical Institution (PNMI) residential/ CSU placement client (for greater than 24 hours)
  • medication/drug diversion
  • Duty to Warn 
  • Neglect- is a pattern of conduct, engaged in without the patient's informed consent, resulting in deprivation of food, water, medication, medical services, shelter, cooling, heating, or other services necessary to maintain minimum physical or mental health. (Examples: Malnutrition, dehydration, pressure sores, unsafe, dangerous, or unsanitary living conditions, untreated medical problems) 

Provider Training

A provider training will be held on Wednesday, June 1, 2022, at 2:00 pm to review these changes. To participate in the training please register online. If you are unable to make the training, you can view the pre-recorded training video or view the instructional guide

For questions regarding this change or the upcoming training please contact Kepro Provider Relations at 1-866-521-0027, Option 3, or via email at ProviderRelationsME@kepro.com

4/19/2022 - Section 97, Appendix D Children's Residential Care Facility (CRCF) Services Changes

Effective May 1, 2022, you must submit a PA to Kepro for all youth determined eligible for CRCF services. The PA will be valid for six months. This includes new CRCF referrals and Transfer CRCF referrals.

If the child does not access CRCF services within the six-month timeframe, you must complete a new referral with all required documentation, including the Behavioral Health Program Coordinator (BHPC) Consult. The new referral will initiate a new assessment with a Kepro clinical reviewer. You can submit the new referral up to 10 days prior to the end of the current authorization and may backdate it up to a maximum of five business days.

Youth Authorized Prior to May 1, 2022

For all youth authorized for CRCF services but not placed prior to May 1, 2022, please submit an extension request in Atrezzo prior to the end of the current authorization period. If approved, we will authorize the extension for six months. If the child does not access CRCF services within the six-month timeframe, you must complete a new referral with all required documentation including the BHPC Consult. The new referral will initiate a new assessment with a Kepro clinical reviewer. You can submit the new referral up to 10 days prior to the end of the current authorization and may backdate it up to a maximum of five business days.

The CRCF services application, directions, and Provider Guide, are available at Maine ASO | Children’s Residential Care Facility (CRCF) Services.

Please contact the Kepro intake team with any referral process questions at 1-866-521-0027 or  IntakeME@kepro.com.

 

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