State of Alabama. School Based Medicaid Claiming Overview
|
|
- Kelley Wheeler
- 8 years ago
- Views:
Transcription
1 State of Alabama School Based Medicaid Claiming Overview
2 What is Medicaid? Medicaid was created on July 30, 1965, through Title XIX of the Social Security Act Medicaid provides health coverage or nursing home coverage to certain categories of income individuals, including: children pregnant women parents of eligible children people with disabilities elderly Each state administers its own Medicaid program while the federal Centers for Medicare and Medicaid Services (CMS) monitors the state run programs and establishes requirements for service delivery, quality, funding, and eligibility standards Medicaid is jointly funded by the state and federal governments, however is managed by the states 2
3 Medicaid & Schools In the educational setting, school personnel often become involved in identifying, coordinating, delivering and monitoring students needs for health and related services Although school staff typically associate these activities as supporting an educational need, many of these functions are reimbursable through the schoolbased Medicaid programs School systems are uniquely positioned to share information regarding Medicaid and covered health services, assist in child enrollment, and the provision and coordination of services The Early and Periodic, Screening, Diagnostic, and Treatment (EPSDT) Program is Medicaid s provision for providing preventative child health services for individuals under the age of 21: Periodic health screening Dental Services Vision services Hearing Services 3
4 Fairbanks Introduction Fairbanks team has designed, implemented and managed Medicaid claiming in 15 states, representing 8,000 LEAs and 10 million students Experienced in statewide implementations Both local and national expertise Offer extensive policy and legal knowledge in school based claiming The Fairbanks system provides a completely web based approach to each step in the Medicaid Program quarterly processes, enabling: Simplified participation and management for both school system and state personnel Data quality checks on all program requirements Built in audit and compliance testing Fairbanks brings significant state and federal audit experience, including: Statewide contracts to serve as a school based Medicaid compliance vendor for technology reviews, program reviews and audit plans Develop, implement and monitor statewide compliance plans consent of Fairbanks LLC 4
5 Program Background In October 1999, Medicaid Administrative Claiming (MAC) was implemented for Alabama school systems The Tallassee City Schools Consortium was formed to enable Alabama school systems to participate in a cost effective MAC program that captures efficiencies afforded by economies of scale, random stratified sampling, and cost allocation principles There are currently 136 participating school systems Alabama Medicaid and Fairbanks have recently implemented a new Direct Service Cost Report Program, which utilizes the same participant list, time study and financial data as the MAC program Both of these programs represent beneficial federal revenue to the schools, while incurring no cost to the state MAC generates $22 25 M annually Cost Report will generate approximately $12 M annually 5
6 Medicaid School Based Services Below are the two distinct Medicaid reimbursement programs that the Alabama school systems participate in: Medicaid School Based Services Medicaid Administrative Claiming (MAC) Federal Medicaid Reimbursement for administrative activities such as: Coordination of medical and mental health related services covered by Medicaid Linking students to Medicaid services Monitoring the delivery of medical and mental health services performed in the school district Direct Service (FFS/Cost Report) Federal Medicaid Reimbursement for direct medical services such as: Speech Therapy Physical Therapy Occupational Therapy 6
7 Medicaid Program Coordination Outreach Identification Referral (MAC) Direct Service (Cost Report) Follow up Coordination Monitoring (MAC) consent of Fairbanks LLC 7
8 MAC & Cost Report Program Roles State Medicaid Agency of Alabama (SMA) The State Medicaid Agency of AL is responsible for MAC/Cost Report program oversight, claims processing, and ongoing audits and desk reviews. Alabama State Department of Education (ALSDE) ALSDE assists/provides feedback in the administration of the MAC/Cost Report programs and provides some of the quarterly data needed for Medicaid claims, i.e. IDCRs. Alabama Association of School Boards (AASB) AASB is an advocate for MAC/Cost Report programs at state agency and federal level to influence policy decisions. They ensure program continuation, and provide oversight to Medicaid program consultant (Fairbanks). This ensures program requirements are appropriately met; therefore reducing school system risk. Fairbanks Fairbanks coordinates with the state agencies, provides MAC/Cost Report program expertise, and administers the quarterly processes, including claim filing, assisting with desk reviews/audits, and providing ongoing training and program support. consent of Fairbanks LLC 8
9 Fairbanks Responsibilities Support the implementation and operation of MAC & DS Cost Reporting, including: Participant List Collection Quarterly MAC Claim Calculation Web based RMTS Quarterly DS Cost Report Collection Quarterly Financial Reporting Annual Cost Report Settlement Offer program knowledge and assistance in policy changes Conduct ongoing quarterly training Manage the operation of web based MAC & DS Cost Reporting claiming system Provide ongoing program and system support through a dedicated Alabama team and a knowledgably staffed Call Center 9
10 School System Responsibilities Serve as liaison between Fairbanks and your school system Designate an RMTS Program Contact who will be responsible for completing the Participant List and reaching Time Study compliance Designate a Financial Contact who will be responsible for submitting the quarterly financial report Participate in training (Quarterly training provided by Fairbanks) Utilize the web based software to: Submit quarterly Participant Lists Ensure system reaches Time Study compliance Submit quarterly financial reports Maintain appropriate audit documentation 10
11 Quarterly Processes Participant List RMTS Time Study Financial Data Collection MAC Claim & Cost Report Calculation Determine who performs Medicaid administrative & direct service activities Determine how much reimbursable activity is performed Determine actual costs associated with these activities Apply appropriate rates to calculate a claim consent of Fairbanks LLC 11
12 Process Efficiencies with Cost Reporting The quarterly participant list has been expanded to include additional categories to cover those participants performing direct services(cost Report) Current Random Moment Time Study (RMTS) results can be used to measure time spent on administrative activities (MAC) as well as direct service activities (Cost Report) Since RMTS also captures the percentage of time spent on direct service activities, this ratio can be applied to those costs collected (quarterly Financial Submission) for those participants on the expanded participant list Claim calculation now occurs simultaneously for both the MAC quarterly claim and direct service Cost Report 12
13 Participant List Process School systems submit a list of eligible participants to include in the time study each quarter, based on provided guidelines The Participant List is used to sample individuals who will participate in the RMTS each quarter The Participant List drives the number of participants eligible for financial reporting The Participant List process is a critical part of ensuring your program receives the appropriate level of MAC and Cost Report reimbursement. 13
14 Random Moment Time Study (RMTS) The random moment time study measures the amount of time spent by eligible staff on both MAC (Administrative) and Direct Service activities RMTS results are used in both the administrative and direct service programs Random time study moments are sampled throughout the quarter: A moment represents one minute at a particular time, and the results are used to determine the reimbursable activities that occur If a participant is sampled, they document what they were doing for a precise moment by answering three questions online Participants may be sampled more than once in a quarter The RMTS methodology has a sample size based on a CMS approved sampling methodology Fairbanks web based RMTS assists in the management of the time studies 14
15 Financial Collection Process To participate in the MAC and Cost Report programs, financial information must be collected, certified, and submitted to Fairbanks each quarter. At the end of each quarter, school systems can begin to report costs via online financial reporting. Eligible costs are reported for staff/positions included on the participant list for the same quarter. Eligible costs can also be reported for Direct Support staff. (This applies to MAC only.) Other purchased services, materials and supplies, and rentals and operating leases are reported via the allocated costs page. (This applies to MAC only.) Reporting all allowable costs ensures MAC claims and Cost Report reimbursements are accurate. Upon completion of financial reporting, Fairbanks begins the claim calculation process using the time study results, reported costs, and reimbursement rates to submit a claim on your behalf. consent of Fairbanks LLC 15
16 Alabama s Dedicated Team Lisa Carnes, Principal Phone: E Mail: lcarnes@fairbanksllc.com Brian Mooney, Project Manager Phone: E Mail: bmooney@fairbanksllc.com Cathy Loverde, Project Analyst Phone: E Mail: cloverde@fairbanksllc.com Fairbanks Client Information Center Phone: E Mail: info@fairbanksllc.com 16
Commonwealth of Kentucky School District Medicaid SBHS Cost Report August 2013
Commonwealth of Kentucky School District Medicaid SBHS Cost Report August 2013 Agenda 1 Fairbanks Introduction 2 Medicaid Program 3 Kentucky Medicaid School Based Program 4 Program Enhancements- SBHS Cost
More informationThe Invisible Transformation: How Medicaid in Schools is Transitioning to a New Paradigm
The Invisible Transformation: How Medicaid in Schools is Transitioning to a New Paradigm October 14, 2009 3:45 5:15 pm Salons E & F Agenda Introductions Session Goals Understanding the New Paradigm Cost
More informationSchool Based Health Services: Medicaid Cost Report and Cost Settlement Training FY 2014-2015
School Based Health Services: Medicaid Cost Report and Cost Settlement Training FY 2014-2015 State of West Virginia Department of Health and Human Services Bureau of Medical Services November 2015 Agenda
More informationNorth Carolina Medicaid Administrative Claiming (MAC) Program for School-Based Services
North Carolina Medicaid Administrative Claiming (MAC) Program for School-Based Services Financial and Business Services Summer Conference Training Research Triangle Park, North Carolina July 25, 2013 Overview
More informationSCHOOL HEALTH SERVICES PROGRAM PROGRAM MANUAL
[Type here] SCHOOL HEALTH SERVICES PROGRAM PROGRAM MANUAL Section 3 Random Moment Time Study The School Health Services Program is a joint effort between the Colorado Department of Education and Department
More informationContents. Staff Involved with ARMAC Time Study 11. Time Study and Reimbursement Methodology 12. Monitoring 15. Attachment I 18.
Arkansas Medicaid Administrative Claiming (ARMAC) Resource Guide FFaal lll 2000066 Arrkkaann ss aa ss Deeppaarrt ttmeennt o f EEdduuccaat ttiionn, io,, SSppeecci iial a ll EEdduuccaat ttiionn io Unni iitt
More informationMEDICAID SCHOOL-BASED ADMINISTRATIVE CLAIMING GUIDE
MEDICAID SCHOOL-BASED ADMINISTRATIVE CLAIMING GUIDE May 2003 MEDICAID SCHOOL-BASED ADMINISTRATIVE CLAIMING GUIDE TABLE OF CONTENTS I. INTRODUCTION...1 II. MEDICAID IN THE SCHOOL SETTING...3 III. INTERAGENCY
More informationMASBO Fall seminar 2015 Bozeman. Medicaid in Schools. Direct Care Services ~ Medicaid Administrative Claiming (MAC)
MASBO Fall seminar 2015 Bozeman Medicaid in Schools Direct Care Services ~ Medicaid Administrative Claiming (MAC) So what is new in the world of Medical Billing of School Based Services? Glad you asked.
More informationAZ RMTS Participant s Guide
AZ RMTS Participant s Guide Revised 07/2013 Page 1 TABLE OF CONTENTS Introduction.. Page 3 Participant Screens A. E-Mail Notifications..... Page 4 B. Accessing Your On-Line RMTS Form..... Page 5 C. Program
More informationSchool-Based Services Department of Public Health and Human Services. Rena Steyaert Program Officer
School-Based Services Department of Public Health and Human Services Rena Steyaert Program Officer A View of Medicaid in Schools Schools have been able to provide and obtain reimbursement from Medicaid
More informationPennsylvania Medicaid School Based Claiming
Pennsylvania Medicaid School Based Claiming SBAP Cost Settlement Training October 2014 www.publicconsultinggroup.com Agenda Cost Settlement Calculation Introduction Cost Summary Report Cost Settlement
More informationLEA Medi-Cal Billing. ~Catching the In-House Wave~ Presenters:
LEA Medi-Cal Billing ~Catching the In-House Wave~ Presenters: Margie Bobe, Los Angeles Unified School District & Cathy Bennett, Sacramento City Unified School District ~Catching the In-House Wave~ Billing
More informationServices which exceed the limitations as listed in the policies and procedures manual must be approved prior to service delivery.
Attachment 3.1-A Page 1i 4.b. EPSDT Related Rehabilitative Services Community Based (continued) Speech-Language Pathology Services Speech-language evaluation of auditory processing, expressive and receptive
More informationState Plan for Title XIX Attachment 1.2-B State of Alaska Page11 ORGANIZATION AND FUNCTIONS OF THE DIVISION RESPONSIBLE FOR THE MEDICAL ASSISTANCE PROGRAM UNDER TITLE XIX OF THE SOCIAL SECURITY ACT The
More informationMedicaid in Education
Medicaid in Education Ben Appling Georgia Department of Community Health August 28, 2014 0 Mission The Georgia Department of Community Health We will provide Georgians with access to affordable, quality
More informationArizona Medicaid School Based Claiming
Arizona Medicaid School Based Claiming Regional Information Session September 2013 www.pcgeducation.com Agenda Direct Service Claiming Annual Cost Settlement.. 3-45 Random Moment Time Study... 46-50 Direct
More informationPOLICY 4060 MEDICAID REIMBURSEMENT FOR HEALTH-RELATED SERVICES. I. Policy Statement
BOARD OF EDUCATION POLICY 4060 MEDICAID REIMBURSEMENT FOR HEALTH-RELATED SERVICES Effective: July 1, 2009 I. Policy Statement The Board of Education recognizes its responsibilities to provide services
More informationWashtenaw Intermediate School District. Medicaid Quality Assurance Plan
Washtenaw Intermediate School District Medicaid Quality Assurance Plan This plan has been developed by the WISD School Based Service Program (SBS) to meet the requirements of the Michigan Department of
More informationSchool-based Medicaid Claiming: IEP and MAC
School-based Medicaid Claiming: IEP and MAC ICASE February 2012 Indiana Department of Education School-based Medicaid contacts: Tracy Brunner, School-based Medicaid Specialist Office of Special Education
More informationStudents SCHOOL HEALTH SERVICES
Board Policy SANGER UNIFIED SCHOOL DISTRICT BP 5141.6(a) Students SCHOOL HEALTH SERVICES The Governing Board recognizes that good physical and mental health is critical to a student's ability to learn
More informationAL-12-003 Attachment 3.1-A Page 2.4b
Page 2.4b 4.b. Early and periodic screening, diagnosis and treatment services for individuals under 21 years of age, and treatment of conditions found. --- (Continued) Effective Date: 04/01/90 (4) Hearing
More informationInnovative State Practices for Improving The Provision of Medicaid Dental Services:
Innovative State Practices for Improving The Provision of Medicaid Dental Services: SUMMARY OF EIGHT STATE REPORTS: (Alabama, Arizona, Maryland, Nebraska, North Carolina, Rhode Island, Texas and Virginia)
More informationSTATE OF NEW JERSEY SCHOOL BASED MEDICAID REIMBURSEMENT PROGRAMS PROVIDER HANDBOOK
STATE OF NEW JERSEY SCHOOL BASED MEDICAID REIMBURSEMENT PROGRAMS PROVIDER HANDBOOK School Year 2014-2015 TABLE OF CONTENTS Introduction 1 CHAPTER 1: MEDICAID OVERVIEW.. 2 CHAPTER 2: SEMI OVERVIEW.. 5 CHAPTER
More informationSCHOOL HEALTH SERVICES PROGRAM PROGRAM MANUAL
SCHOOL HEALTH SERVICES PROGRAM PROGRAM MANUAL Section 7 Quality Assurance The School Health Services Program is a joint effort between the Colorado Department of Education and Department of Health Care
More informationCMS Policy on Medicaid in Schools
CMS Policy on Medicaid in Schools Coverage, Reimbursement, and Time Studies PRESENTERS: Coverage Melissa Harris/Jean Close Reimbursement Mary Cieslicki Time Study - Judi Wallace/Sharon Brown NAME Conference
More informationMedicaid Administrative Claiming (MAC) Program. New Mexico MAC Program Random Moment Time Study (RMTS) Sample Email Notifications
New Mexico MAC Program Random Moment Time Study (RMTS) Sample Email Notifications 1 Sampled Participant Notification Email Name: District: Job Category: Sampled Moment:
More informationOVERVIEW OF KENTUCKY Outreach MEDICAID AND KCHIP
OVERVIEW OF KENTUCKY Outreach MEDICAID AND KCHIP Lisa Lee Director, Medicaid Division of Provider Operations Program Director, Kentucky Children s Health Insurance Program (KCHIP) September 2011 Background
More informationMEDICAID PAYMENTS FOR SCHOOL-BASED HEALTH SERVICES HOLYOKE, MASSACHUSETTS - JULY 1999 THROUGH JUNE 2000 -
Department of Health and Human Services OFFICE OF INSPECTOR GENERAL MEDICAID PAYMENTS FOR SCHOOL-BASED HEALTH SERVICES HOLYOKE, MASSACHUSETTS - JULY 1999 THROUGH JUNE 2000 - JANET REHNQUIST Inspector General
More informationClarification of Medicaid Coverage of Services to Children with Autism
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-26-12 Baltimore, Maryland 21244-1850 CMCS Informational Bulletin DATE: July 7, 2014
More informationEarly and Periodic Screening, Diagnosis, and Treatment (EPSDT) Current Approved State Plan Language
Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) Current Approved State Plan Language Limitations on Attachment 3.1-A Page 9 Type of Service Covered for Medi-Cal eligibles under 21 years
More informationLouisiana Medicaid School-Based Health Center Presentation December 2011
Louisiana Medicaid School-Based Health Center Presentation December 2011 1 Services Available Professional Services, think of a SBHC as a physician clinic dropped into the school setting. KIDMED Services,
More information9/26/2012. Managing Your School Based Medicaid Billing Program. Objectives
Managing Your School Based Medicaid Billing Program NAME Conference, October 2012 1 Elaine Lerner, New Jersey DOE Kathleen Cummins Merry, Wayne RESA, Michigan Stephen Wright, New York State Education Department
More informationMASSHEALTH School-Based Medicaid Program
MASSHEALTH School-Based Medicaid Program USER GUIDE Effective July 2013 (Revised June 2014) School Based Medicaid Program User Guide Table of Contents Overview... 1 Becoming a School-Based Medicaid Provider...
More informationMichigan Online Staff Pool List Training. August 2010
Michigan Online Staff Pool List Training August 2010 Agenda Description of Staff Pools Targeted Case Management Staff Requirements and Activities Personal Care Services Staff Requirements and Activities
More informationMAWD or Marketplace?
MAWD or Marketplace? What Pennsylvanians with Disabilities Need to Know About Choosing Health Insurance Coverage Summary Choosing health insurance coverage that best meets one s needs is important, especially
More informationILLINOIS GUIDE FOR SCHOOL-BASED HEALTH SERVICES ADMINISTRATIVE CLAIMING
Illinois Department of Healthcare and Family Services ILLINOIS GUIDE FOR SCHOOL-BASED HEALTH SERVICES ADMINISTRATIVE CLAIMING For Local Education Agencies Participating in the Medicaid School-Based Health
More informationState of Alabama. Medicaid Dental Review
State of Alabama Medicaid Dental Review October 2010 Executive Summary The Centers for Medicare & Medicaid Services (CMS) is committed to improving pediatric dental care in the Medicaid program reflecting
More informationTABLE OF CONTENTS - RI Comprehensive Health Insurance Legislation
TABLE OF CONTENTS - RI Comprehensive Health Insurance Legislation 23-93-1. Purpose. 23-93-2. Definitions. 23-93-3. Rhode Island Comprehensive Health Insurance Program. (a) Organization. (b) Director. 23-93-4.
More informationNational Training Program
National Training Program Module 12 Medicaid and the Children s Health Insurance Program Session Objectives This session will help you Describe eligibility, benefits, and administration of Medicaid Define
More informationSchool Based Access Program (SBAP) Medicaid Cost Reporting and Cost Settlement Training for FY 2014-2015
School Based Access Program (SBAP) Medicaid Cost Reporting and Cost Settlement Training for FY 2014-2015 Commonwealth of Pennsylvania Department of Human Services Department of Education October - December
More informationDisability Rights Ohio Frequently Asked Questions about Medicaid: Early and Periodic Screening, Diagnosis and Treatment (EPSDT)
50 West Broad Street, Suite 1400 Columbus, Ohio 43215-5923 Tel. 614-466-7264 local / 800-282-9181 in Ohio TTY 614-728-2553 / 800-858-3542 in Ohio Fax 800-644-1888 Web: disabilityrightsohio.org Disclaimer:
More informationSTATE OF MISSOURI MO HEALTHNET SCHOOL DISTRICT ADMINISTRATIVE CLAIMING MANUAL
STATE OF MISSOURI MO HEALTHNET SCHOOL DISTRICT ADMINISTRATIVE CLAIMING MANUAL SECTION 1 - PREFACE...4 SECTION 2 - INTRODUCTION...5 2.1 DIRECT SERVICES...5 2.2 ADMINISTRATIVE CLAIMING...5 2.3 PRIMARY AND
More informationMEDICAID REIMBURSEMENT GUIDELINES FOR. PARTICIPATING LOCAL EDUCATION AGENCIES (LEAs)
MEDICAID REIMBURSEMENT GUIDELINES FOR PARTICIPATING LOCAL EDUCATION AGENCIES (LEAs) I. General Overview The District of Columbia s Medicaid program allows for Medicaid reimbursement for medically necessary
More informationCalifornia School-Based MAA Manual SECTION 3. MAA Glossary
California School-Based MAA Manual SECTION 3 MAA Glossary Subject Page MAA Glossary 3-1 June 2004 Actual Client Count (ACC) Allowable Time Audit File Cal-SAFE Centers for Medicare & Medicaid Services (CMS)
More informationMedicaid School-Based Services for Recipients Under 21 Years of Age. Program Activity Time Study Codes
Medicaid School-Based Services for Recipients Under 21 Years of Age Program Activity Time Study Codes The following 17 codes are to be used in completing the time study: CODE 1A CODE 1B CODE 2A CODE 2B
More informationperform cost settlements to ensure that future final payments for school-based services are based on actual costs.
Page 2 Kerry Weems perform cost settlements to ensure that future final payments for school-based services are based on actual costs. In written comments on our draft report, the State agency concurred
More informationIndiana Coalition for Human Services ICHS) Comments on the Healthy Indiana Plan (HIP) 2.0 Waiver Application (submitted 9/20/14)
Indiana Coalition for Human Services ICHS) Comments on the Healthy Indiana Plan (HIP) 2.0 Waiver Application (submitted 9/20/14) Indiana Coalition for Human Services (ICHS) appreciates the opportunity
More informationTIME STUDY CODES_2012-2013
1A. Non-Medicaid outreach Distributing general program information TIME STUDY CODES_2012-2013 - Conducting outreach campaigns to educate the public about healthy lifestyles - Informing individuals about
More informationDivision of Medical Assistance Programs. Services Directory
Services Directory DMAP Organization Chart... 1 Quick reference... 2 Main contact information... 2 DMAP mail codes... 2 E-mail addresses by topic... 2 Helpful telephone numbers... 2 Office of the State
More informationVermont Medicaid Training 2013-2014. Copyright MSB 2013 Revision Date 9/4/13
Vermont Medicaid Training 2013-2014 Copyright MSB 2013 Revision Date 9/4/13 SCHOOL-BASED Health Services Program The Medicaid School-Based Health Services Program is used by the State to generate Medicaid
More informationAn Overview of Medicaid in North Carolina *
An Overview of Medicaid in North Carolina * Lisa J. Berlin Center for Child and Family Policy Duke University Abstract: In North Carolina, as in other states, Medicaid cost containment is an increasingly
More informationApproved Private Schools: Changes to Participation in the School-Based ACCESS Program November 24, 2014
Approved Private Schools: Changes to Participation in the School-Based ACCESS Program November 24, 2014 Agenda Introductions Financial Management Review (FMR) FMR Final Report Revised Payment Process Committee
More information16 XU AUG. Review of Oregon s Medicaid Payments for School-Based Health Services Direct Care in State Fiscal Year 2000 (A-10-01-00006)
DEPARTMENT OF HEALTH & HUMAN SERVICES Office of Inspector General Washington, D.C. 20201 TO: FROM: SUBJECT: AUG 16 XU Neil Donovan Director, Audit Liaison Staff Centers for Medicare & Medicaid Services
More informationCalifornia School-Based Medi-Cal Administrative Activities Manual
California School-Based Medi-Cal Administrative Activities Manual Produced by: DEPARTMENT OF HEALTH CARE SERVICES In Cooperation with: Centers for Medicare and Medicaid Services, California Local Educational
More informationSTATE PLAN UNDER TITLE XIX OF THE SOCIAL SECURITY ACT
Page 1 PROFESSIONAL MEDICAL PERSONNEL AND SUPPORTING STAFF USED IN THE ADMINISTRATION OF THE PROGRAM AND THEIR RESPONSIBILITIES Attached is a description of the kinds and number of the medical assistance
More informationYour Medicare Options
H H FOR GUIDE ESSENTIAL AN H H AN ESSENTI Your Medicare Options H MEDICARE BENEFICIARIES IN ALABAMA RIES IN ALABAMA Y0106_GBKLT_15 Accepted Thank you for your interest in Blue Cross and Blue Shield of
More informationMay 2006. American Speech-Language-Hearing Association 1. 2006 Focused Initiative on Health Care Reimbursement. Last updated February 2009.
Summary of the Department of Health and Human Services Office of Inspector General's (OIG) Findings of the Delivery of Medicaid Speech- Language Pathology Services in the Schools 1 May 2006 Lack of documentation
More informationSTATE OF MISSOURI MO HEALTHNET SCHOOL DISTRICT ADMINISTRATIVE CLAIMING MANUAL
STATE OF MISSOURI MO HEALTHNET SCHOOL DISTRICT ADMINISTRATIVE CLAIMING MANUAL SECTION 1 - PREFACE...4 SECTION 2 - INTRODUCTION...5 2.1 DIRECT SERVICES...5 2.2 ADMINISTRATIVE CLAIMING...6 2.3 PRIMARY AND
More informationTable of Contents. State Plan Amendment (SPA) #: 14-06 This file contains the following documents in the order listed:
Table of Contents State/Territory Name: Louisiana State Plan Amendment (SPA) #: 14-06 This file contains the following documents in the order listed: 1) Approval Letter 2) CMS 179 3) Approved SPA Pages
More informationCommonwealth of Virginia. Medicaid Dental Program Review. October 2010
Commonwealth of Virginia Medicaid Dental Program Review October 2010 EXECUTIVE SUMMARY The Centers for Medicare & Medicaid Services (CMS) is committed to improving pediatric dental care in the Medicaid
More informationDMAP Services Directory. November 2010 Department of Human Services Division of Medical Assistance Programs
DMAP Services Directory November 2010 Department of Human Services Division of Medical Assistance Programs DMAP mailing information Oregon DHS - Division of Medical Assistance Programs 500 Summer St NE,
More informationResources and Services Directory for Head Injury and Other Conditions
Resources and Services Directory for Head Injury and Other Conditions Section 2: Accessing and Paying for TBI and Related Services 1000 NE 10 TH ST. OKC, OK 73117 TEL 405.271-3430 OR 800.522.0204 (OK only)
More informationMedicaid $ for School-based Nursing Services and Activities
Medicaid $ for School-based Nursing Services and Activities Indiana Department of Education School-based Medicaid Claiming contacts: Tracy Brunner, School-based Medicaid Specialist Office of Special Education
More informationDEPARTMENT OF HEALTH AND HUMAN SERVICES OFFICE OF AUDIT SERVICES 233 NORTH MICHIGAN AVENUE CHICAGO, ILLINOIS 60601. April 23,2002
DEPARTMENT OF HEALTH AND HUMAN SERVICES OFFICE OF AUDIT SERVICES 233 NORTH MICHIGAN AVENUE CHICAGO, ILLINOIS 60601 REGION V OFFICE OF INSPECTOR GENERAL UN: A-05-0 l-00044 April 23,2002 Mr. Michael O Keefe
More informationThis Agreement is based on the following general principles:
CERTIFIED MEDICAID MATCH AGREEMENT BETWEEN THE AGENCY FOR HEALTH CARE ADMINISTRATION AND COUNTY FOR THE REIMBURSEMENT OF SPECIFIED SUBSTANCE ABUSE TREATMENT SERVICES FOR MEDICAID RECIPIENTS The Agency
More informationMaryland Medicaid Program. Aaron Larrimore Medicaid Department of Health and Mental Hygiene May 15, 2012
Maryland Medicaid Program Aaron Larrimore Medicaid Department of Health and Mental Hygiene May 15, 2012 1 Maryland Medicaid In Maryland, Medicaid is also called Medical Assistance or MA. MA is a joint
More informationOhio Medicaid. A Health Care. ohio medicaid
Ohio Medicaid A Health Care Program for Ohioans with Limited Income ohio medicaid Who can Medicaid help? To qualify for Medicaid, you must meet Medicaid citizenship requirements (certain non-citizens may
More informationFlorida Medicaid and Implementation of SB 2654
Florida Medicaid and Implementation of SB 2654 Shachi Mankodi Counsel to the Chief of Staff Florida Agency for Health Care Administration Autism Compact Presentation September 18, 2008 Overview What is
More informationNC Health Choice. Publication date: September 1999 OVERVIEW. What is it?
NC Health Choice Publication date: September 1999 OVERVIEW What is it? NC Health Choice is a free or reduced cost health insurance program for uninsured children birth through age 18. Who is it for? Children
More informationFlorida Medicaid. Medicaid Certified School Match Program Coverage and Limitations Handbook. Agency for Health Care Administration
Florida Medicaid Medicaid Certified School Match Program Coverage and Limitations Handbook Agency for Health Care Administration This page is intentionally blank. This page is intentionally blank. UPDATE
More informationImportant Benefi ts for Medicaid Eligible Children: EPSDT EARLY & PERIODIC SCREENING DIAGNOSIS & TREATMENT. Ohio Legal Rights Service
Important Benefi ts for Medicaid Eligible Children: EPSDT EARLY & PERIODIC SCREENING DIAGNOSIS & TREATMENT Ohio Legal Rights Service On October 26, 2005, Ohio Legal Rights Service (OLRS) fi led a lawsuit
More informationFAQ #1 NEWARK PUBLIC SCHOOLS SPECIAL EDUCATION CLASS ACTION LAWSUIT SETTLEMENT. General Questions
FAQ #1 NEWARK PUBLIC SCHOOLS SPECIAL EDUCATION CLASS ACTION LAWSUIT SETTLEMENT General Questions What is a class action? A class action is a lawsuit in which a large group of people who have been harmed
More informationU.S. Department of Health and Human Services. Centers for Medicare & Medicaid Services Region II
U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services Region II FINAL REPORT New Jersey EPSDT Review Report Dental Services March 2008 Site Visit Executive Summary The Early
More informationState of Connecticut Department of Social Services School Based Child Health Program School District Contact Information Update Form
School Based Child Health rogram The purpose of this form is to provide the DSS SBCH program with current contact information for your district as it relates to the various aspects of the program. lease
More informationMEDICAID AND SCHOOL HEALTH: A TECHNICAL ASSISTANCE GUIDE. August 1997
MEDICAID AND SCHOOL HEALTH: A TECHNICAL ASSISTANCE GUIDE August 1997 This guide contains specific technical information on the Medicaid requirements associated with seeking payment for coverable services
More informationMEDICAID BUY-IN for Workers with Disabilities
MEDICAID BUY-IN for Workers with Disabilities April 15, 2014 1 Medicaid Buy-In for Workers with Disabilities Medicaid Buy-In Affordable health care coverage for people with disabilities who work and earn
More informationPBS and Medicaid. Comments about Medicaid
PBS and Medicaid Comments about Medicaid Medicaid, as set out in the Social Security Act, is an aggravated assault on the English language, resistant to attempts to understand it. District Court, Schweiker
More information8.310.12.1 ISSUING AGENCY: New Mexico Human Services Department (HSD). [8.310.12.1 NMAC - N, 11-1-14]
TITLE 8 SOCIAL SERVICES CHAPTER 310 HEALTH CARE PROFESSIONAL SERVICES PART 12 INDIAN HEALTH SERVICE AND TRIBAL 638 FACILITIES 8.310.12.1 ISSUING AGENCY: New Mexico Human Services Department (HSD). [8.310.12.1
More informationSince outpatient surgical procedures are limited to approved medically necessary services, no additional benefit limitations are imposed.
ATTACHMENT 3.1-A Page 1c AMOUNT, DURATION AND SCOPE OF SERVICES PROVIDED Revised: July 1, 2009 CATEGORICALLY NEEDY Outpatient Hospital Services (Continued) Outpatient Surgical Procedures Coverage of outpatient
More informationSMD# 14-006. Re: Medicaid Payment for Services Provided without Charge (Free Care) December 15, 2014. Dear State Medicaid Director:
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-26-12 Baltimore, Maryland 21244-1850 SMD# 14-006 Re: Medicaid Payment for Services Provided
More informationPresentation to Joint Committee for Senate State Affairs and Health and Human Services. Executive Commissioner Thomas M. Suehs November 23, 2010
Presentation to Joint Committee for Senate State Affairs and Health and Human Services Executive Commissioner Thomas M. Suehs November 23, 2010 Update Since Last Hearing Guidance from the federal government:
More informationBasic and Enhanced Plan of Action in North TN
3.R ESSENTIAL PROVIDERS BASIC PLAN (For Low-Income Children and Working-Age Adults) The Basic Benchmark Benefit Package includes Clinic Services and Rehabilitative Services furnished by certain essential
More informationDEPARTMENT OF HEALTH & HUMAN SERVICES MEDICAID PROGRAM OVERVIEW
DEPARTMENT OF HEALTH & HUMAN SERVICES MEDICAID PROGRAM OVERVIEW North Carolina General Assembly Fiscal Research Division February 2005 Overview Purpose of Medicaid Impact of Medicaid - On the State Economy
More informationHB 686-FN-A - AS INTRODUCED. establishing a single payer health care system and making an appropriation therefor.
0 SESSION -0 0/0 HOUSE BILL AN ACT -FN-A establishing a single payer health care system and making an appropriation therefor. SPONSORS: Rep. McNamara, Hills ; Rep. Suzanne Smith, Graf ; Rep. Moody, Rock
More informationAcademic health centers play an essential
of Current Ryan D. Brutger, MA Together, academic and community health centers can treat patients, perform research, and expand clinical trials in ways that neither would be able to do on their own. Academic
More informationHealth Insurance Overview
Spotsylvania County Open Enrollment August 10 to 28, 2015 Plan Year: October 1, 2015 to September 30, 2016 Health Insurance Overview All Full Time employees are eligible to participate in the County Health
More informationNew Mexico Medicaid Guide for School- Based Services
New Mexico Medicaid Guide for School- Based Services A Guide for Local Education Agencies, Regional Education Cooperatives, and Other State-Funded Education Agencies Produced and Issued by: New Mexico
More informationConnecticut Data as of July 2003
Mental Health and Substance Abuse Services in Medicaid and SCHIP in Connecticut As of July 2003, 378,961 people were covered under Connecticut Medicaid/SCHIP programs. There were 364,692 enrolled in the
More informationPROVIDER BULLETIN No. 05-05
PROVIDER BULLETIN No. 05-05 February 15, 2005 TO: FROM: BY: RE: Speech Therapy Providers Mary Steiner, Interim Administrator, Medicaid Division Marsha Rekart, Program Specialist Medicaid coverage of speech
More informationEXECUTIVE SUMMARY BACKGROUND
EXECUTIVE SUMMARY BACKGROUND Title XIX of the Social Security Act (the Act) established the Medicaid program to pay for the medical assistance costs of certain individuals and families with limited incomes
More informationGuidance for Becoming a MYPAC Provider. Contact: Jennifer Grant Jennifer.Grant@medicaid.ms.gov Phone: (601) 359-3809
Guidance for Becoming a MYPAC Provider Contact: Jennifer Grant Jennifer.Grant@medicaid.ms.gov Phone: (601) 359-3809 1.0 Scope of Work... 3 1.1 Purpose... 3 1.2 Authority... 3 1.3 Background... 3 1.4 Intent
More informationLEA Frequently Asked Questions
LEA Frequently Asked Questions 1). We would like you to consider adding orientation/mobility services and psychological evaluations and counseling. We feel that such services would be provided in a rehabilitative
More informationMEDICAID REIMBURSEMENTS FOR SCHOOL-BASED MEDICAL SERVICES
J@cob320 J 3333333333333333 STATE OF NORTH CAROLINA OFFICE OF THE STATE AUDITOR BETH A. WOOD, CPA MEDICAID REIMBURSEMENTS FOR SCHOOL-BASED MEDICAL SERVICES PUBLIC SCHOOLS OF ROBESON COUNTY FINANCIAL RELATED
More informationIn total, Massachusetts overstated its Medicaid claim for reimbursement by $5,312,447 (Federal share).
Page 2 Wynethea Walker In total, Massachusetts overstated its Medicaid claim for reimbursement by $5,312,447 (Federal share). Massachusetts did not provide specific guidance to local education agencies
More informationHEALTH INSURANCE CONNECTORS SHOULD BE DESIGNED TO SUPPLEMENT PUBLIC COVERAGE, NOT REPLACE IT By Judith Solomon
820 First Street NE, Suite 510 Washington, DC 20002 Tel: 202-408-1080 Fax: 202-408-1056 center@cbpp.org www.cbpp.org January 29, 2007 HEALTH INSURANCE CONNECTORS SHOULD BE DESIGNED TO SUPPLEMENT PUBLIC
More informationMedicaid Coverage & Prior Authorization for Applied Behavior Analysis Services
Medicaid Coverage & Prior Authorization for Applied Behavior Analysis Services Bureau of Medicaid Services October 2012 Developed by: Yolanda Sacipa 1 Learning Objectives Provide guidance about Florida
More informationM E D I C A I D P R O G R A M F O R U N I N S U R E D A D U L T S I N C O O K C O U N T Y
CountyCare M E D I C A I D P R O G R A M F O R U N I N S U R E D A D U L T S I N C O O K C O U N T Y What is CountyCare? A Medicaid program through the Affordable Care Act Section 1115 of the Social Security
More informationIHCP bulletin INDIANA HEALTH COVERAGE PROGRAMS BT201503 JANUARY 27, 2015
IHCP bulletin INDIANA HEALTH COVERAGE PROGRAMS BT201503 JANUARY 27, 2015 FSSA announces the NEW Healthy Indiana Plan! Coverage for qualifying Hoosiers will start effective Feb. 1, 2015 The Indiana Family
More informationMedicaid and CHIP FAQs: Implementing Hospital Presumptive Eligibility Programs January 2014
DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-26-12 Baltimore, Maryland 21244-1850 Overview Medicaid and CHIP FAQs: Implementing Hospital
More informationPROVIDER POLICIES & PROCEDURES
PROVIDER POLICIES & PROCEDURES HOMEMAKER-HOME HEALTH AIDE MEDICATION ADMINISTRATION SERVICES The purpose of this policy is to provide guidance to providers enrolled in the Connecticut Medical Assistance
More information