Brought to you by: Amy Kanter – Resources For SBS Providers Kevin Bauer– CHAMPS Revalidation Update on Free Care SBS Website Mike Grasseschi - Overview.

WELCOME to

MEDICAID SCHOOL BASED

SERVICES 201

Brought to you by:Amy Kanter – Resources For SBS Providers

Kevin Bauer– CHAMPS Revalidation

Update on Free Care

SBS Website

Mike Grasseschi - Overview of the New RMTS System

August 2015 - School Based Services Conference 3

CHAMPS Revalidation

• Revalidation is required every five years

• Claims will deny if enrollment is not revalidated on time

• Steps for revalidation:• Go to your user information just as you would for any

modification• Go through each step ensuring that the information is current

• After necessary changes are made, close out and move on to the next step

• If no changes are necessary, close out and move to the next step

Submit the modification to Provider Enrollment for review

Contact Provider Enrollment with any questions

August 2015 - School Based Services Conference 4

Update on Free Care

• “Dear State Medicaid Director” letter issued December 15, 2014• Radical departure from prior “Free Care” interpretation

• What was the “Free Care Rule?”• The free care rule states that Medicaid funds may not be

used to pay for services that are provided for free to everyone in the community

• Free Care includes 504 services (we think)

• How does it affect SBS?• Fee-for-Service Methodologies• Full-Cost Reimbursement Methodologies• Reimbursement at Cost Methodologies

August 2015 - School Based Services Conference 5

Free Care (cont.)

• How does it affect Michigan SBS?• Free Care is not reimbursable according to the Provider

Manual• 504 services are not reimbursable according to the State Plan• Under a reimbursement at cost methodology impact may be

minimal

• What are we doing about it?• Massachusetts is looking to be the first state to allow

reimbursement for Free Care & 504 services• PCG is conducting an impact study with New Jersey to

determine how Free Care reimbursement affects states using methodologies other than Fee-for-Service

• What are our next steps?

August 2015 - School Based Services Conference 6

SBS WebsiteFrom http://michigan.gov/mdch select Providers

August 2015 - School Based Services Conference 7

Select Providers

August 2015 - School Based Services Conference 8

Select Medicaid

August 2015 - School Based Services Conference 9

Select Billing and Reimbursement

August 2015 - School Based Services Conference 10

Select Provider Specific Information

August 2015 - School Based Services Conference 11

Select School Based Services

August 2015 - School Based Services Conference 12

SBS Website & Databases

August 2015 - School Based Services Conference 13

MI SBS Conference Presentations

August 2015 - School Based Services Conference 14

MAER & MAER Instruction Section

August 2015 - School Based Services Conference 15

RMTS Section

Short Overview of the New RMTS System2015 School-Based Services Conference

August 17-18, 2015

August 2015 - School Based Services Conference 17

The PCG Claiming System

ISD/LEA Coordinators now use one system for all of the following:

Staff Pool Lists Calendars

Random Moment Time

Study

Quarterly Financials

August 2015 - School Based Services Conference 18

Accessing the PCG Claiming Systemhttps://claimingsystem.pcgus.com/mi

August 2015 - School Based Services Conference 19

Navigating the PCG Claiming System

1 23 4 5

1. Quarter Dropdown

2. ISD/LEA Menu

3. Access the Staff Pool List

4. Access the Calendar

5. Access Quarterly Financials

August 2015 - School Based Services Conference 20

Questions?

August 2015 - School Based Services Conference 21

Contact us

[email protected]

877-395-5017

Resources For SBS Providers

Amy Kanter

Michigan Department of Community Health Hospital & Clinic Reimbursement Division [email protected]

517-373-4522

Resources For SBS Providers

• MDCH

• Michigan Medicaid Provider Manual

• Medicaid Policy Bulletins

• Provider “L” Letters

• Dropbox

• Audit Reports (Federal & Michigan)

• Regulations, Newsletters, Prior Meeting Agendas

• PCG

• Other Intermediate School Districts

Medicaid Provider Manual

Medicaid Provider Manual

The Michigan Medicaid Provider Manual contains guidelines for ALL Providers

Published online quarterly with publish date at bottom of each page

Latest changes are color-highlighted and dated

Medicaid Policy Bulletins

Provider “L” Letters

SBS Resources-Dropbox• Cloud application allows sharing few or hundreds of files

• By invitation only—Jane Reagan invites you

• Saves space on computers by avoiding huge attachments to emails

• View on your desktop computer, smart phone, tablet

MI SBS Program in Dropbox

Screen shot shows the way Dropbox is organized on this computer

Folders are sorted alphabetically

Last time any item in the folder was modified shows on the date

The MI SBS Program had 124 items in it the day this screenshot was made

Public Consulting Group• RMTS Quarterly Process

• Staff Pool Lists

• Random Moments

• Financial Collection

• Generate AOP Claim

• Claim Breakdown sent to ISDs

• Collect PCS/TCM costs to be verified by ISDs

Other Intermediate School Districts• Newsletters

• Oakland Schools (Medicaid Matters)

• Wayne RESA (Medicaid Messenger)

• Tip Sheets

• Forms

• Informational Brochures

• Parental Consent (English, Spanish, Arabic)

• Prescription/Authorizations

Parental Consent - Arabic

QUESTIONS

Thank You!

CONTACTSPolicy

Kevin Bauer, MDCH

517-241-8398

[email protected]

Cost Reporting and Cost Settlement

Amy Kanter, MDCH

517- 373-4522         

[email protected]

Office of Audit

John Lambert, MDCH

517-335-4792

[email protected]