OVERVIEW WITH SELECT TOPICS

Similar documents
Care Transitions Training Videoconference December 17, 2009 Questions and Answers

Service Authorization Process: Nursing Facility Services Minnesota Senior Health Options (MSHO) & Minnesota Senior Care Plus (MSC+)

Healthcare Claiming. Help Desk Q&A, Reports and Claiming Tips. Presenter: Stacey Alsdurf. SSIS Fiscal Mentor Meeting Healthcare Claiming 02/11/15

Medicaid Home- and Community-Based Waiver Programs

OBRA Scenarios. This section contains the more frequently used sequencing charts for

SSIS Software Specification. Healthcare Claiming - Requirements

NURSING FACILITY LEVEL OF CARE (NF LOC) CHANGE. Question and Answer

Social Service Time Study (SSTS) Codes, Activities and Definitions

Minnesota Statewide Quality Assurance Activities by Service Type: A Working Document. Minnesota Quality Assurance Panel February, 2007

2015 Provider Resource Materials. HealthPartners Products for State Public Programs

Care Coordination Delegation Guidelines for Community Members

Minnesota Department of Human Services Waiver Review Initiative

Managed Care in Minnesota

Professional Treatment Services in Facility-Based Crisis Program Children and Adolescents

Minnesota Case Management Reform

Case Study: Michigan s Money Follows the Person Demonstration

Florida Medicaid and Implementation of SB 2654

Molina Healthcare of Ohio Nursing Facility Orientation Molina Dual Options MyCare Ohio 2014

Title 10 DEPARTMENT OF HEALTH AND MENTAL HYGIENE

Chapter 27 Non-Emergency Transportation Services

Assertive Community Treatment/Case Management Services/ Health Home Care Management NYC 2013 Upstate/Downstate

REPORTING AND INVESTIGATING ABUSE AND NEGLECT IN ILLINOIS

US ARMY NAF EMPLOYEE LONG TERM CARE INSURANCE

Willamette University Long-Term Care Insurance Outline of Coverage

MINISTERIAL ADJUSTMENT No. 1 to HUMAN SERVICES AND PUBLIC HEALTH PERSONAL/PROFESSIONAL SERVICE AGREEMENT

Medical Assistance Spenddown Requirements and Processes

Chapter 16 Restricted Recipient Program

CHAPTER 5 SERVICE DESCRIPTIONS. Inpatient Hospital Psychiatric Services. Service Coverage

Medicaid IMD Exclusion and Options for MHDS February 29, 2012

Title 10 DEPARTMENT OF HEALTH AND MENTAL HYGIENE

Iowa Medicaid Integrated Health Home Provider Agreement General Terms

Research Summary. ACA SECTION 2401, COMMUNITY FIRST CHOICE OPTION (Section 1915(k) of the Social Security Act); MARYLAND STATE PLAN AMENDMENT SUMMARY

LCTS Public Health Activity Code Reference Guide

Long Term Care Medicaid. Long Term Care (LTC) Medicaid

Understanding Changes to Medicaid Behavioral Health Care in New York

POLICY # SUBJECT: INPATIENT CERTIFICATION AND AUTHORIZATION

130 CMR: DIVISION OF MEDICAL ASSISTANCE MASSHEALTH COVERAGE TYPES TABLE OF CONTENTS

and the uninsured June 2005 Medicaid: An Overview of Spending on Mandatory vs. Optional Populations and Services

KANSAS MEDICAL ASSISTANCE PROGRAM. Provider Manual. Psychiatric Residential Treatment Facility

Department of Human Services

5/3/2016. Value-Based Purchasing in Minnesota Medicaid AGENDA

Community Living Exchange Collaborative: A National Technical Assistance Program. Funded by Centers for Medicare and Medicaid Services (CMS)

130 CMR: DIVISION OF MEDICAL ASSISTANCE

CHAPTER 77A ADULT MENTAL HEALTH REHABILITATION SERVICES PROVIDED IN/BY COMMUNITY RESIDENCE PROGRAMS

Medical Assistance Eligibility and the Long Term Care Partnership in Minnesota

HOME & COMMUNITY BASED SERVICES AND THE MEDICAID WAIVERS IN CONNECTICUT

Alternative Care Minnesota s Other Program for LTSS Serving Seniors

Service Coordination Core Training Module Component 1

Guide to Programs & Services

Application for CFSS Consultation and Financial Management Services. Section 1915(b) (4) Waiver Fee-for-Service Selective Contracting Program

Mode & Service Function Information

Florida Medicaid. Nursing Facility Services Coverage Policy

Moving Through Care Settings (Don t Send Me to a Nursing Home)

Arkansas Department of Human Services. Your Guide To Medicaid Estate Recovery In Arkansas

Introduction to One Care. MassHealth plus Medicare.

CHAPTER 37H. YOUTH CASE MANAGEMENT SERVICES SUBCHAPTER 1. GENERAL PROVISIONS Expires December 2, 2013

Transportation Assistance Program Verification Checklist

STATE AGENCY WAIVER PROGRAMS: COMMUNITY LONG TERM CARE. Jocelin Dawson, SCDHHS Lori Manos, SCDDSN Susan Bolt, SCDHHS

NASHIA: AN INTRODUCTION TO THE MICHIGAN MONEY FOLLOWS THE PERSON PROGRAM. Gayle Haven Project Director, MFP Program October 9, 2013

HCBS MR/DD Medical Alert

256B.055 ELIGIBILITY CATEGORIES.

ICD-10. October 1, 2015

MINNESOTA RECORDS RETENTION SCHEDULE

UB-92 Billing Instructions for Inpatient Chemical Dependency Services

Assisted Living/Housing with Services in Minnesota

Behavioral Health Provider Training: Substance Abuse Treatment Updates

Medical Education and Research Cost (MERC) Grant Application Fiscal Year 2013 Clinical Training

STATE OF ARIZONA MEDICAID ESTATE RECOVERY PROGRAM. DE-810 (Rev. 07/15) Page 1

MI HEALTH LINK ACRONYMS AND KEY TERMS

State of Alabama Medicaid Agency

North Carolina Medicaid Special Bulletin

Testimony on the Department of Human Services. Overview of Services Provided to Individuals with Disabilities. Kevin Hancock

General GAP Questions

Transcription:

OVERVIEW WITH SELECT TOPICS

movinghomemn.mfp @state.mn.us (651) 431-3951 (888) 240-4756

AGENDA History and Services Who Can Qualify? How to Enroll Approval Process and Transitioning SSIS Reporting Billing and Claims Q & A

JOHN A. ANDERSON Program Deputy Director

WHAT IS MOVING HOME MINNESOTA (MHM)? A federal demonstration project known as Money Follows the Person nationally Allows states to develop, implement and evaluate demonstration and supplemental services not otherwise covered by the state s HCBS waivers

MISSION STATEMENT Creating choice and opportunity for Minnesotans to move from institutions to homes and communities, live more independently, and enhance the quality of their own lives.

WHY MHM MATTERS TO THE CLIENT Focus on Community Integration Person-Centered Planning Planning for safety (Risk Mitigation) Additional services, alternatives and choices Expanded Benefit Set to aid in transitioning and supporting the individual in the community for the first 365 days

WHY MHM MATTERS TO THE LEAD AGENCY It provides more tools and resources to assist in transitioning the client into the community. It can allow for an additional 180 days of Transitional Services if the client was unable to successfully transition using Relocation Service Coordination (RSC).

WHY MHM MATTERS TO THE LEAD AGENCY It can serve as an alternative to utilizing a waiver. It provides compliance to the Olmstead Act and the Jensen Settlement.

SERVICES Approximately 30 different services available

PATRICK ALFORD Enrollment Specialist

WHO IS ELIGIBLE? Resident of Minnesota Any age or disability group 90 consecutive days in a Qualifying Institution

WHO IS ELIGIBLE? Qualified to received Medicaid (Medical Assistance) Medical Assistance paid for at least one (1) day of institution care prior to discharge

WHAT IS A QUALIFYING INSTITUTION? Nursing Facilities / Hospitals Intermediate Care Facility for Developmentally Disabled (ICF/DD) Institution for Mental Disease (IMD) (under 21 or 65 years of age and older)

QUALIFIED INSTITUTIONS RLVA DESCRIPTION VAILD FOR MHM? 41 Nursing Facility I - Medicare certified 42 Nursing Facility II - Non-Medicare certified Yes, but exclusive of Medicare days Yes 43 ICF/DD - Public or private Yes 47 RTC/ICF-DD - Not IMD Yes 48 Medical hospital >30 days Yes, but only if the stay is 90 or more days.

QUALIFIED INSTITUTIONS RLVA DESCRIPTION VAILD FOR MHM? 50 RTC - MI psychiatric inpatient hospital - IMD Yes, but only if the person is under 21 or 65 years and older. 51 Rule 31 CD - IMD Yes, but only if the person is under 21 or 65 years and older and the person has a co-occurring MH diagnosis. CD diagnosis only is not sufficient to enroll in MHM. 52 Rule 36 MI - IMD Yes, but only if the person is under 21 or 65 years and older. 53 Private psychiatric inpatient hospital - IMD Yes, but only if the person is under 21 or 65 years and older.

QUALIFIED INSTITUTIONS RLVA DESCRIPTION VAILD FOR MHM? 58 RTC - CD psychiatric inpatient hospital - IMD 59 Out-of-state SED residential treatment facility for children - IMD Yes, but only if the person is under 21 or 65 years and older, and has a cooccurring MH diagnosis. CD diagnosis only is not sufficient to enroll in MHM. Yes, but only if the facility is paid an allinclusive institutional rate and one day is paid by MA. 78 IMD Nursing Home Yes, but only if the person is under 21 or 65 years and older

INSTITUTION FOR MENTAL DISEASE Hospital, Nursing Facility, or other institution with more than 16 beds Primary focus is providing diagnosis, treatment or care of mental health disorders (42 CFR Ch IV)

MENTAL HEALTH IMD PROGRAMS Anoka Metro Regional Treatment Center Andrew Board and Care (Minneapolis) Prairie Saint Johns (Fargo) Richard P Stadter Psychiatric Center (Grand Forks)

CHEM DEP IMD PROGRAMS

HOW TO APPLY Intake Form can be completed by the client, a family member, social worker, case manager, care coordinator, or an other invested caregiver.

METHODS TO APPLY Online via edocs: (search for document #: 5032) By Mail: Moving Hove MN PO Box 64250 Saint Paul MN 55164-0250

METHODS TO APPLY By Fax: (651) 431-7745 By Phone: -Senior Linkage Line (800) 333-2433 -Disability Linkage Line (866) 333-2466

INTAKE FORM DHS-5032

WHO ACTS AS LEAD AGENCY? Health Care Product Enrolled in MSHO or MSC+ (65 and over) Enrolled in SNBC (under or over 65) PMAP straight MA, not enrolled in Managed Care Acting Lead Agency Managed Care Organization County or Tribe County or Tribe County or Tribe

APPROVAL PROCESS: INTAKE Participant Identified Completed Intake Form Submitted

APPROVAL PROCESS: VERIFICATION DHS determines initial eligibility DHS notifies client/lead Agency of result If eligible, Lead Agency assigns Transition Coordination agency

APPROVAL PROCESS: COMPLETION Transition Coordinator meets with client Informed Consent is signed/returned Client/Lead Agency informed and services can now begin and be billed

COMMUNICATION FORM DHS-6759H

TRANSITION COORDINATOR RESPONSIBILITIES Meets with client for initial face-to-face to acquire signature on and complete: -Informed Consent (DHS-6795I) -Housing Transitions Worksheet (DHS-6759G)

INFORMED CONSENT DHS-6759I

LEAD AGENCY RESPONSIBILITIES Pre-transition: Screenings (MnCHOICES/LTCC/DD) Assessments Determination/Approval of Services

LEAD AGENCY RESPONSIBILITIES Pre-transition: Assignment of Transition Coordinator MMIS maintenance (RLVA etc)

RSC VS MHM Relocation Service Coordination Not necessarily Person-Centered. If client uses 180 days of RSC first and doesn t move, client could receive MHM if eligible. Services are primarily focused on communication and coordination. Might be able to be used to relocate out of state. Some services require Waiver Transitional Services to receive. MHM Transition Coordination Person-Centered Planning utilized in all phases of transition. If client uses MHM first and 180 days were exhausted, client cannot access RSC. Payments for expenses to secure housing, for furnishings and supplies available. Client can move to another state participating in MFP. All services available with or without waiver services.

TRANSITIONING SERVICES Participants will be eligible for 180 days of Transition Coordination Services once the Informed Consent is signed.

TRANSITION PLANNING Development of a Person Centered Plan for Transition

TRANSITION COORDINATION Transportation to research/locate housing opportunities Funds for furnishings, deposits, moving expenses Purchase of items relating to establishing and setting up a household

TRANSITION COORDINATOR REPORTING RESPONSIBILITIES Estimated transition date when known Request for assistance with employment or mental health services Actual transition date including housing information and type

TRANSITION COORDINATOR REPORTING RESPONSIBILITIES Referral of client to a MHM Case Management Agency (if not going out on waiver) or warm hand-off to Waiver Case Manager Client status or condition changes

WHAT IS A QUALIFIED RESIDENCE? Home, owned or leased by the individual or individual s family Apartment with an individual lease

WHAT IS A QUALIFIED RESIDENCE? Community-Based residential setting in which no more than four (4) unrelated people reside Assisted Living for those aged 55+ Adult Foster Care (Corporate or Family owned)

WHAT IS A QUALIFIED RESIDENCE? Any residence must have lockable access and egress. Must include separate living, sleeping, bathing, and cooking areas.

ADULT FOSTER LICENSED FOR UP TO 5 INDIVIDUALS If the residence has a fifth crises bed, the residence is not qualified for MHM.

POST TRANSITION SERVICES Participants of all populations can be eligible for 365 days of post-transition services once they move to the community (with or without a waiver)

POST TRANSITION SERVICES Case Management (waiver or MHM Demo CM required) Case Consultation and Collaboration Comprehensive Community Support Services

POST TRANSITION SERVICES Customized Employment Services Overnight Assistance Environmental Modifications Durable Medical Equipment and Assistive Technology

LEAD AGENCY RESPONSIBILITIES Lead Agencies will assess if waivered services are appropriate at discharge. For those not being enrolled on a waiver, a referral to MHM Demonstration Case Management will be made.

HANDING OFF THE CASE WARM hand-off between Transition Coordinator and Case Manager

CASE MANAGER RESPONSIBILITIES Case Manager added to MAXIS [STAT/SWKR panel] to receive notices. Open communication with County Financial Worker for proper handling of other benefits (cash, SNAP, etc.)

Questions?

SSIS Reporting

SSIS ENTRY New Not Automated HCPCS/Modifiers added for MHM Use Reports to pull Time & Payments associated to MCPCS/Modifiers Payments- Not Automated Potentially Billable Time- Not Automated Potentially Billable

SSIS ENTRY CON T Use County sub-service for tracking Use Special Studies for tracking By Client or Workgroup Send enhancement requests to Help Desk for Reports to help pull this data

TIME- NOT AUTOMATED POTENTIALLY BILLABLE REPORT

PAYMENTS NOT AUTOMATED POTENTIALLY BILLABLE REPORT

COUNTY SUB-SERVICE TIME RECORD

COUNTY SUB-SERVICE PAYMENTS

Moving Home Minnesota HCPCS/Modifiers Services Reference Guide rev 07/10/14

HCPCS/ Modifiers Description Unit Type Services Activities The Moving Home Minnesota codes added to SSIS are in the Not Automated Claim Category. The start date for all codes is 06/01/2013. The following services were added to SSIS for staff provided time. H0040 U6 Assertive Community Treatment, MHM Day 438 - Assertive Community Treatment (ACT) Client contact Collateral contact Consultation Coordination Documentation Paraprofessional case management Service delivery Service planning Transportation Group time -.5 hours Group time - 1 hour Group time - 1.5 hours Group time - 2 hours Group time - 4 hours

MAYCHEE MUA MAI YANG Provider Training and Communications

PROVIDER MANUAL

PROVIDER ENROLLMENT

DEMO & SUPPLEMENTAL LINK

DEMO & SUPPLEMENTAL SERVICES

RETURN TO ENROLLED PROVIDER HOME PAGE

MHCP ENROLLED PROVIDERS HOME

SELECTING PROVIDER TYPE

MHCP ENROLLED PROVIDERS- MHM

COMMUNICATIONS Check the following for updated MHCP coverage policy and billing procedures: Provider Home Page Latest Manual revisions Provider News

COMMUNICATION LINKS

MHCP PROVIDER CALL CENTER (651) 431-2700 or (800) 366-5411 Option 1 Provider Help Desk Option 5 Provider Enrollment Option 6 MN-ITS Administration Only Option 7 EVS Eligibility Option 9 MCHP & General Information

PROVIDER TRAINING

PROVIDER TRAINING HOMEPAGE

MHM BILLING HOME PAGE

FREE MHM BILLING LABS Attend in person or via webinar Wednesday 07/29/2015 8:30am 3:00pm DHS: 444 Lafayette Rd, St Paul, 55101 Room 1235 Scheduled quarterly through July 2016

FREE MHM BILLING LAB Register online: MHM Billing Training Page Computer, internet access, speakers or headphones required for webinar

MHM PROVIDER LIST Log-in into your MN-ITS Account Left Hand Side Navigation Select Provider List

Questions?

Thank you! Don t forget to request your PDF tool kit! movinghomemn.mfp @state.mn.us