Attachment F STC Compliance

Size: px
Start display at page:

Download "Attachment F STC Compliance"

Transcription

1 Section I Preface Section II Historical Description of the Demonstration Section III General Program Requirements 1 Federal Non-Discrimination Statutes 2 Medicaid and CHIP Law 3 Changes in Medicaid and CHIP Law 4 Changes in Federal Law 5 State Plan Amendments 6 Changes subject to the amendment process 7 Amendment process 8 Extension of the Demonstration Documentation required is provided through the renewal application. 9 Demonstration phase-out Not applicable 10 CMS Right to Terminate or Suspend Not applicable 11 Finding of Non-Compliance Not applicable 12 Withdrawal of Waiver Authority Not applicable 13 Submission of Amendments and Transition Plan re: ACA 14 Adequacy of Infrastructure 15 Public Notice 16 FFP Not applicable Section IV Eligibility 17 Eligibility groups affected by the demonstration 18 Expansion Groups 19 Demonstration Population Summary 20 Eligibility/Post-eligibility Treatment of Income and Resources for Institutionalized Individuals 21 Transfer of Assets Section V Benefits 22 Alternative Benefit Plan 23 MLTSS benefits 24 Supports Program benefits 25 ASD Program benefits The state is currently developing a package of services to include in the Medicaid State Plan through EPSDT under guidance from CMS. The benefit package will include the services offered under the ASD Pilot. 26 ID/DD-MI benefits 27 IDD/OOS benefits Not operationalized 1 R e n e w a l A p p l i c a t i o n A t t a c h m e n t E

2 28 SED Program benefits 29 MATI benefits 30 Short-term NF Stays 31 Cost Sharing Section VII Managed Care Requirements 32 Benefits Excepted from Managed Care 33 Care Coordination & Referral under Managed Care 34 Managed Care Contracts 35 Public Contracts 36 Network Requirements 37 Demonstrating Network Adequacy 38 Provider Credentialing 39 EPSDT Compliance 40 Advisory Committee 41 Mandatory Enrollment 42 Choice of MCO 43 MCO Selection 44 Notice for Change in MCO Network Section VIII HCBS & MLTSS Requirements 45 Administrative Authority 46 Home and Community-based Characteristics 47 Health and Welfare of Enrollees 48 Demonstration Participant Protections 49 Critical Incident Management System 50 Managed Care Grievance/Complaint System 51 Fair Hearings 52 Plan of Care 52(d): In a focus study done by the EQRO and released in draft to the State this spring, it was determined that not all POCs had a back-up plan as required by the STC and MCO contract. Reeducation was done by the state and the EQRO will be reviewing for compliance with the next audit. 53 Option for Participant Direction of certain HCBS and MLTSS Section IX Behavioral Health 54 Behavioral Health Organization Children s BHO was operationalized and is in compliance 55 Behavioral Health for Children 56 Behavioral Health for Adults Not operationalized 2 R e n e w a l A p p l i c a t i o n A t t a c h m e n t E

3 57 Behavioral Health Home The Behavioral Health Home is provided through a FFS Model 58 Services Provided by the BHO/ASO 59 Duplication of Payment Section X 3 R e n e w a l A p p l i c a t i o n A t t a c h m e n t E Managed Long Term Services and Supports 60 Transition of Existing 1915c Programs 61 Notice of Transition to Program Participants 62 Transition from FFS to Managed Care 63 Readiness Review Requirements 64 Steering Committee 65 Transition of Care Period 66 Money Follows the Person 67 Nursing Facility Diversion 68 Nursing Facility Transition to Community Plan 69 Level of Care Assessment 70 Participant Protections under MLTSS 71 Institutional & Community-based MLTSS 72 Care Coordination for MLTSS Section XI Special Targeted HCBS Programs 73 HCBS Programs 74 Network and Adequacy Requirements 75 Provider Credentialing 76 Non-duplication of Services 77 Supports Program 78 ASD Pilot Program The state is currently revising its ASD Pilot program to come into compliance with the CMS bulletin released in July 2014 regarding providing Autism services through EPSDT. 79 ID/DD-MI Pilot Program 80 IDD-OOS Program Not operationalized 81 SED Program 82 MATI Section XII Premium Assistance Programs 83 Premium Support Program Section XIII Quality 84 Administrative Authority 85 Quality for Managed Care/MLTSS 86 Quality for Fee-for-Service HCBS Programs

4 87 Content of Quality Strategies 88 Oversight Process: Monitoring Activities by State/EQRO 89 Revision of Quality Strategies/Reporting Section XIV Funding Pools 90 Terms and Conditions Applying to Pools Generally 91 Transition Payments 92 DSRIP Pool 93 FFP for DSRIP 94 Life Cycle of Five-Year Demonstration 95 Limits on Pool Payments 96 Transition Plan for Funding Pools Due to CMS by June 30, 2016 Section XV General Reporting Requirements 97 General Financial Requirements 98 MLTSS Data Plan for Quality 99 Monthly Enrollment Report 100 Monthly Monitoring Calls The state has not had monthly calls with CMS due to scheduling issues on both sides. The state has made itself available when CMS has had any questions. 101 Quarterly Progress Reports 102 Annual Report Section XVI Administrative Requirements 103 General Administrative Requirements Section XVII General Financial Requirements Under Title XIX 104 Reporting Expenditures 105 Expenditures Subject to Budget Agreement 106 Administrative Costs 107 Claiming Period 108 Reporting Member Months 109 Standard Medicaid Funding Process 110 Extent of FFP for the Demonstration 111 Sources of Non-Federal Share 112 State Certification of Funding Conditions Section XVIII General Financial Requirements Under Title XXI 113 Quarterly Expenditure reports under CMS Reporting requirements for Title XXI 4 R e n e w a l A p p l i c a t i o n A t t a c h m e n t E

5 115 Timeframe for submitting claims under the Demonstration 116 Standard CHIP Funding Process 117 Certify Non-Federal Share 118 Title XXI Funding limit 119 Total Federal title XXI Funding 120 Expenditures for Outreach and Admin 121 Exhaustion of Title XXI Funds 122 Notice of Title XIX drawdown for Medicaid Expansion 123 Continuance of Federal Rules Section XIX Monitoring Budget Neutrality for the Demonstration 124 Limit on Title XIX Funding 125 Risk 126 Calculation and Application of Budget Neutrality Limit 127 Impermissible DSH, Taxes or Donations 128 Trend Rates for PMPMs 129 Supplemental Tests 130 Composite Federal Share Ratios 131 Exceeding Budget Neutrality Budget Neutrality has not been exceeded. 132 Enforcement of Budget Neutrality Section XX Evaluation of the Demonstration 133 Submission of Draft Evaluation Design 134 Final Evaluation Design and Implementation 135 Evaluation Reports The Draft Interim Evaluation report is included in the Renewal Application. The Final Evaluation report is due July 1, Cooperation with Federal Evaluators 5 R e n e w a l A p p l i c a t i o n A t t a c h m e n t E

FEB DEPARTMENT OF HEALTH & HUMAN SERVICES

FEB DEPARTMENT OF HEALTH & HUMAN SERVICES DEPARTMENT OF HEALTH & HUMAN SERVICES FEB - 2 2016 Centers for Medicare & Medicaid Services Administrator Washington, DC 20201 Mr. Darin Gordon Director Bureau of Tenn Care Tennessee Department of Finance

More information

Children and Adults Health Programs Group. November 18, 2014

Children and Adults Health Programs Group. November 18, 2014 DEPARTMENT OF HEALTH & HUMAN SERVICES Centers for Medicare & Medicaid Services 7500 Security Boulevard, Mail Stop S2-01-16 Baltimore, Maryland 21244-1850 Children and Adults Health Programs Group November

More information

Medicaid and CHIP Managed Care Final Rule MLTSS

Medicaid and CHIP Managed Care Final Rule MLTSS Medicaid and CHIP Managed Care Final Rule MLTSS John Giles, Technical Director Division of Quality and Health Outcomes Children and Adult Health Programs Group Debbie Anderson, Deputy Director Division

More information

EXTERNAL QUALITY REVIEW COMPLIANCE MONITORING REPORT

EXTERNAL QUALITY REVIEW COMPLIANCE MONITORING REPORT Michigan Department of Health and Human Services (MDHHS) EXCERPTS Behavioral Health and Developmental Disabilities Administration Prepaid Inpatient Health Plans 2015 2016 EXTERNAL QUALITY REVIEW COMPLIANCE

More information

Wayne State University. Student Handbooks linear feet. 5 manuscript boxes.

Wayne State University. Student Handbooks linear feet. 5 manuscript boxes. Wayne State University. Student Handbooks. 1921-2000 2.5 linear feet. 5 manuscript boxes. Creator: Detroit Junior College, Detroit Teachers College, College of the City of Detroit, Detroit Municipal Colleges,

More information

Medicaid Comprehensive Waiver Special Terms and Conditions

Medicaid Comprehensive Waiver Special Terms and Conditions Medicaid Comprehensive Waiver Special Terms and Conditions VALERIE J. HARR MEDICAID DIRECTOR DIVISION OF MEDICAL ASSISTANCE AND HEALTH SERVICES MEDICAL ASSISTANCE ADVISORY COUNCIL MEETING JUNE 25, 2012

More information

Section 2703: State Option to Provide Health Homes for Enrollees with Chronic Conditions

Section 2703: State Option to Provide Health Homes for Enrollees with Chronic Conditions Section 2703: State Option to Provide Health Homes for Enrollees with Chronic Conditions Center for Medicaid, CHIP, and Survey & Certification Centers for Medicare & Medicaid Services Background. A goal

More information

1.1 INTRODUCTION GENERAL INFORMATION... 2 A. APPLICANT AND POTENTIAL APPLICANT S RIGHTS... 2

1.1 INTRODUCTION GENERAL INFORMATION... 2 A. APPLICANT AND POTENTIAL APPLICANT S RIGHTS... 2 1.1 INTRODUCTION... 1 1.2 GENERAL INFORMATION... 2 A. APPLICANT AND POTENTIAL APPLICANT S RIGHTS... 2 1. Right To Apply... 2 2. Right To General Information... 2a 3. Right To Consideration For All Programs...

More information

NJ FamilyCare 1115 Comprehensive Demonstration Application for Renewal

NJ FamilyCare 1115 Comprehensive Demonstration Application for Renewal NJ FamilyCare 1115 Comprehensive Demonstration Application for Renewal Strengthening Medicaid: Alignment & Redesign Through Integration NJ Department of Human Services 1/6/2017 Table of Contents Executive

More information

LANCASTER COUNTY OFFICE OF AGING Aging Services Area Plan Budget Public Hearing

LANCASTER COUNTY OFFICE OF AGING Aging Services Area Plan Budget Public Hearing 2015-2016 Aging Services Area Plan Budget Public Hearing County Government Center 150 North Queen Street Planning Commission Conference Room #104 Lancaster, PA February 1, 2016 12 Noon AGENDA 1. Call to

More information

Medicaid and CHIP Managed Care Final Rule (CMS-2390-F)

Medicaid and CHIP Managed Care Final Rule (CMS-2390-F) Medicaid and CHIP Managed Care Final Rule (CMS-2390-F) Beneficiary Experience and Provisions Unique to Managed Long Term Services and Supports (MLTSS) Center for Medicaid and CHIP Services Background This

More information

Enrolled Copy S.B. 58 REPEAL OF NURSING FACILITIES ASSESSMENT. Sponsor: Peter C. Knudson

Enrolled Copy S.B. 58 REPEAL OF NURSING FACILITIES ASSESSMENT. Sponsor: Peter C. Knudson Enrolled Copy S.B. 58 REPEAL OF NURSING FACILITIES ASSESSMENT 2001 GENERAL SESSION STATE OF UTAH Sponsor: Peter C. Knudson This act repeals the Nursing Facility Assessment Act. This act appropriates for

More information

Florida MEDS AD Section 1115 Demonstration CMS11-W-00205/4 Renewal Request

Florida MEDS AD Section 1115 Demonstration CMS11-W-00205/4 Renewal Request Centers for Medicare & Medicaid Services Office of Information Services Information Services Design & Development Group 7500 Security Blvd Baltimore, MD 21244-1850 Section 1115 Demonstration Program Florida

More information

JOB ADVERTISEMENT. Eastern and Southern Africa Higher Education Centers of Excellence Project (ACE II) 1. Project Background

JOB ADVERTISEMENT. Eastern and Southern Africa Higher Education Centers of Excellence Project (ACE II) 1. Project Background Eastern and Southern Africa Higher Education Centers of Excellence Project (ACE II) 1. Project Background JOB ADVERTISEMENT Launched in October 2016 and financed by the World Bank, the ACE II Project supports

More information

State roles & responsibilities in Medicaid managed long-term care

State roles & responsibilities in Medicaid managed long-term care State roles & responsibilities in Medicaid managed long-term care Andrea Maresca Director of Federal Policy and Strategy April 24, 2012 Agenda Core State Managed Care Design Considerations Plan Payment

More information

NACC Member Value Survey November 15, Discoveries

NACC Member Value Survey November 15, Discoveries NACC Member Value Survey November 15, 2012 Discoveries I. What is the current Membership Status in the NACC? A. 77% - Board Certified B. 23% - Not Board Certified II. III. IV. How long have you been a

More information

MARATHON COUNTY DEPARTMENT OF SOCIAL SERVICES REQUEST FOR PROPOSALS RESTORATIVE JUSTICE PROGRAMS

MARATHON COUNTY DEPARTMENT OF SOCIAL SERVICES REQUEST FOR PROPOSALS RESTORATIVE JUSTICE PROGRAMS I. PURPOSE MARATHON COUNTY DEPARTMENT OF SOCIAL SERVICES REQUEST FOR PROPOSALS RESTORATIVE JUSTICE PROGRAMS The Marathon County Department of Social Services (Purchaser) is requesting proposals to provide

More information

COUNTY HUMAN SERVICES BLOCK GRANT REPORTING INSTRUCTIONS

COUNTY HUMAN SERVICES BLOCK GRANT REPORTING INSTRUCTIONS INSTRUCTIONS FOR THE ANNUAL INCOME AND EXPENDITURE REPORT Block Grant County with Joinder Arrangement FISCAL YEAR 2014-2015 COUNTY HUMAN SERVICES BLOCK GRANT REPORTING INSTRUCTIONS ISSUED BY: PENNSYLVANIA

More information

Medicaid Managed Specialty Supports and Services Concurrent 1915(b)/(c) Waiver Program FY 17 Attachment P7.9.1

Medicaid Managed Specialty Supports and Services Concurrent 1915(b)/(c) Waiver Program FY 17 Attachment P7.9.1 QUALITY ASSESSMENT AND PERFORMANCE IMPROVEMENT PROGRAMS FOR SPECIALTY PRE-PAID INPATIENT HEALTH PLANS FY 2017 The State requires that each specialty Prepaid Inpatient Health Plan (PIHP) have a quality

More information

NJ FamilyCare Update

NJ FamilyCare Update NJ FamilyCare Update Valerie Harr Deputy Commissioner New Jersey Department of Human Services Home Care and Hospice Association of New Jersey June 22, 2017 1 NJ FamilyCare Covered Populations Parents/caretakers

More information

Protecting the Rights of Low-Income Older Adults

Protecting the Rights of Low-Income Older Adults Protecting the Rights of Low-Income Older Adults November 17, 2014 Consumer Rights in Medicaid MLTSS Advocating for choice, protection and quality Gwen Orlowski, National Senior Citizens Law Center www.nsclc.org

More information

DHCS Update: Major Initiatives and Strategies Towards Standardization

DHCS Update: Major Initiatives and Strategies Towards Standardization DHCS Update: Major Initiatives and Strategies Towards Standardization Javier Portela, Division Chief Managed Care Operations Department of Health Care Services ICE 2016 Annual Conference December 2016

More information

Alternative in lieu of Services under Managed Care

Alternative in lieu of Services under Managed Care NC Tide Conference November 16, 2016 Catharine Goldsmith, Manager Children s Behavioral health Services, DMA Al Greco, Section Chief Managed Care & Waiver Reimbursement, DMA Alternative in lieu of Services

More information

New York Children s Health and Behavioral Health Benefits

New York Children s Health and Behavioral Health Benefits New York Children s Health and Behavioral Health Benefits DRAFT Transition Plan for the Children s Medicaid System Transformation August 15, 2017 DRAFT Transition Plan for the Children s Medicaid System

More information

ROSIE D. V. ROMNEY PLAINTIFFS FINAL REMEDIAL PLAN. August 18, 2006

ROSIE D. V. ROMNEY PLAINTIFFS FINAL REMEDIAL PLAN. August 18, 2006 ROSIE D. V. ROMNEY PLAINTIFFS FINAL REMEDIAL PLAN August 18, 2006 TABLE OF CONTENTS SECTION 1: SCOPE AND PRINCIPLES 1 1. Purpose and Scope of Plan 1 A. Purpose and Goals of the Plan 1 B. Scope of the Plan

More information

Florida Medicaid Family Planning Waiver

Florida Medicaid Family Planning Waiver Florida Medicaid Family Planning Waiver 1115 Research and Demonstration Waiver #11-W-00135/4 Public Notice Document April 1, 2014 Posted on Agency Website http://ahca.myflorida.com/medicaid/family_planning/extension.shtml

More information

PUBLIC BEACH & COASTAL WATERFRONT ACCESS PROGRAM. NC Department of Environmental Quality Division of Coastal Management

PUBLIC BEACH & COASTAL WATERFRONT ACCESS PROGRAM. NC Department of Environmental Quality Division of Coastal Management APRIL 2018 PUBLIC BEACH & COASTAL WATERFRONT ACCESS PROGRAM State Authorization: Coastal Area Management Act NCGS 113A-124; 113A-134.1] NC Department of Environmental Quality Division of Coastal Management

More information

Managed Long-Term Services and Supports: Understanding the Impact of the New Medicaid Managed Care Regulations

Managed Long-Term Services and Supports: Understanding the Impact of the New Medicaid Managed Care Regulations July 1, 2015 Managed Long-Term Services and Supports: Understanding the Impact of the New Medicaid Managed Care Regulations HealthManagement.com HealthManagement.com HealthManagement.com HealthManagement.com

More information

Disability Rights California

Disability Rights California Disability Rights California California s protection and advocacy system BAY AREA REGIONAL OFFICE 1330 Broadway, Suite 500 Oakland, CA 94612 Tel: (510) 267-1200 TTY: (800) 719-5798 Toll Free: (800) 776-5746

More information

Floyd County Public Schools 140 Harris Hart Road NE Floyd, VA 24091

Floyd County Public Schools 140 Harris Hart Road NE Floyd, VA 24091 Floyd County Public Schools 140 Harris Hart Road NE Floyd, VA 24091 Phone: (540) 745-9400 / Fax: (540) 745-9496 CLASSIFIED SALARY SCHEDULE FOR 2016-2017 (Jul-Nov) (Page 1) 06/28/16 Step I II III IV V VII

More information

Draft Children s Managed Care Transition MCO Requirements

Draft Children s Managed Care Transition MCO Requirements Draft Children s Managed Care Transition MCO Requirements OVERVIEW On February 1 st, New York State released for stakeholder feedback a draft version of the Medicaid Managed Care Organization (MCO) Children

More information

Medicaid Managed Care. Long-term Services and Supports Trends

Medicaid Managed Care. Long-term Services and Supports Trends Medicaid Managed Care Long-term Services and Supports Trends Medicaid Managed Care Statistics As of 2011, 74.2% of Medicaid Enrollees were enrolled in a Medicaid Managed Care system As of 2011, California,

More information

Medicaid Overview. Home and Community Based Services Conference

Medicaid Overview. Home and Community Based Services Conference Centers for Medicare & Medicaid Services Medicaid Overview Home and Community Based Services Conference September 11, 2012 1 Overview of Presentation Basic facts about the Medicaid State Plan/program requirements

More information

VIRGINIA S MEDICARE AND MEDICAID INTEGRATION EXPERIENCE 12/2/2016

VIRGINIA S MEDICARE AND MEDICAID INTEGRATION EXPERIENCE 12/2/2016 VIRGINIA S MEDICARE AND MEDICAID INTEGRATION EXPERIENCE The Honorable Dr. William Hazel Secretary of Health and Human Resources Commonwealth of Virginia Why Is It Important to Integrate Medicare and Medicaid

More information

Health Homes (Section 2703) Frequently Asked Questions

Health Homes (Section 2703) Frequently Asked Questions Health Homes (Section 2703) Frequently Asked Questions Following are Frequently Asked Questions regarding opportunities made possible through Section 2703 of the Affordable Care Act to develop health home

More information

Option Description & Impacts First Full Year Cost Option 1

Option Description & Impacts First Full Year Cost Option 1 Option 1 Grant coverage for nonemergency services to those adult undocumented immigrants who meet CMISP income and resource standards. Estimate for first year: This option reverses the December 2009 County

More information

Standard Operating Procedure (SOP) 1 for Chapter 105 Dam Safety Program Review of Chapter 105 New Dam Permit November 2, 2012

Standard Operating Procedure (SOP) 1 for Chapter 105 Dam Safety Program Review of Chapter 105 New Dam Permit November 2, 2012 Bureau of Waterways Engineering and Wetlands Standard Operating Procedure (SOP) 1 for Chapter 105 Dam Safety Program Review of Chapter 105 New Dam Permit This SOP describes the procedures and work flows

More information

State of New York Department of Health

State of New York Department of Health Health Homes Provider Manual Billing Policy and Guidance State of New York Department of Health The purpose of this Manual is to provide Medicaid policy and billing guidance to providers participating

More information

TERMS OF REFERENCE FOR CONSULTANTS

TERMS OF REFERENCE FOR CONSULTANTS TERMS OF REFERENCE FOR CONSULTANTS A. Consulting Firm The Asian Development Bank (ADB) will engage a consulting firm in accordance with its Guidelines on the Use of Consultants (2013, as amended from time

More information

Medicaid Simplification

Medicaid Simplification Medicaid Simplification This Act authorizes the director of the state department of health and welfare to restructure the state Medicaid program in order to achieve improved health outcomes for Medicaid

More information

Select Topics in Implementing an Integrated Medicaid Managed Long-Term Care Program

Select Topics in Implementing an Integrated Medicaid Managed Long-Term Care Program Select Topics in Implementing an Integrated Medicaid Managed Long-Term Care Program TennCare Overview Tennessee s Medicaid Agency Tennessee s Medicaid Program Managed care demonstration implemented in

More information

The Association of Universities for Research in Astronomy. Award Management Policies Manual

The Association of Universities for Research in Astronomy. Award Management Policies Manual The Association of Universities for Research in Astronomy Award Management Policies Manual May 1, 2014 The Association of Universities for Research in Astronomy Award Management Policies Manual Table of

More information

Medicaid: Current Challenges and Future Prospects

Medicaid: Current Challenges and Future Prospects Medicaid: Current Challenges and Future Prospects Diane Rowland, Sc.D. Executive Vice President, Henry J. Kaiser Family Foundation Executive Director, Kaiser Commission on Medicaid and the Uninsured The

More information

REQUEST FOR PROPOSAL (RFP) FOR. Consultant. Return Qualifications to:

REQUEST FOR PROPOSAL (RFP) FOR. Consultant. Return Qualifications to: REQUEST FOR PROPOSAL (RFP) FOR Consultant Return Qualifications to: Jackie Cruz Executive Director, Office of Institutional Advancement & Hartnell College Foundation Hartnell Community College District

More information

General Administration Office Structure Effective Date: Supersedes: References: P&P-O-100; CRS, P&P L-100

General Administration Office Structure Effective Date: Supersedes: References: P&P-O-100; CRS, P&P L-100 DOUGLAS COUNTY SHERIFF S OFFICE General Administration Office Structure Effective Date: 01-12-16 Supersedes: 02-27-15 References: P&P-O-100; 16-2.5-101 CRS, P&P L-100 Approval: Sheriff Number of Pages:

More information

Presentation: Medicaid and CHIP Managed Care Final Rule (CMS-2390-F)

Presentation: Medicaid and CHIP Managed Care Final Rule (CMS-2390-F) Presentation: Medicaid and CHIP Managed Care Final Rule (CMS-2390-F) Overview and Background The final rule is the first update to Medicaid and CHIP managed care regulations in over a decade. This final

More information

5.3 Report of the Committee on Tourism and Competitiveness (CTC)

5.3 Report of the Committee on Tourism and Competitiveness (CTC) 5.3 Report of the Committee on Tourism and Competitiveness (CTC) 59 th Meeting of the UNWTO Regional Commission for Africa Addis Ababa, Ethiopia 19 April 2017 CTC MEMBERS (2015-2019) Invited Member: AENOR

More information

Texas Section 1115 Uncompensated Care Waiver Update. Texas Critical Access Hospital Conference June 21, 2018

Texas Section 1115 Uncompensated Care Waiver Update. Texas Critical Access Hospital Conference June 21, 2018 Texas Section 1115 Uncompensated Care Waiver Update Texas Critical Access Hospital Conference June 21, 2018 Texas Section 1115 Uncompensated Care Waiver Update Waiver allows for Managed Care DSRIP UC Additional

More information

Application for a 1915(c) Home and Community-Based Services Waiver

Application for a 1915(c) Home and Community-Based Services Waiver Application for a 1915(c) Home and Community-Based Services Waiver PURPOSE OF THE HCBS WAIVER PROGRAM Page 1 of 117 The Medicaid Home and Community-Based Services (HCBS) waiver program is authorized in

More information

Drug Medi-Cal Organized Delivery System Demonstration Waiver

Drug Medi-Cal Organized Delivery System Demonstration Waiver Drug Medi-Cal Organized Delivery System Demonstration Waiver All County Orientation to Standard Terms and Conditions & Fiscal Provisions Presentation by DHCS and Harbage September 28, 2015 Overview of

More information

University of Auckland Doctoral Scholarships

University of Auckland Doctoral Scholarships University of Auckland Doctoral Scholarships Code: 43 Faculty: All Applicable study: PhD, DClinPsy or the research component of an approved doctorate Closing date: No application required Tenure: Up to

More information

DECODING THE JIGSAW PUZZLE OF HEALTHCARE

DECODING THE JIGSAW PUZZLE OF HEALTHCARE DECODING THE JIGSAW PUZZLE OF HEALTHCARE HPCANYS Leadership Institute November 6, 2015 Carla R. Williams, MPA Director, O Connell & Aronowitz Healthcare Consulting Group WHAT IS GOING ON? ENVIRONMENT ACA

More information

Estimated Decrease in Expenditure by Service Category

Estimated Decrease in Expenditure by Service Category Public Notice for June 2009 Release PUBLIC NOTICE COLORADO MEDICAID Department of Health Care Policy and Financing Fee-for-Service Provider Payments Effective July 1, 2009, in an effort to reduce expenditures

More information

CDBG Owner-Occupied Housing Rehabilitation Administration Plan Requirements

CDBG Owner-Occupied Housing Rehabilitation Administration Plan Requirements September 2016 CDBG Owner-Occupied Housing Rehabilitation Administration Plan Requirements Each community receiving a CDBG award to implement an owner-occupied housing rehabilitation program must prepare

More information

Request for an Amendment to a 1915(c) Home and Community-Based Services Waiver

Request for an Amendment to a 1915(c) Home and Community-Based Services Waiver Page 1 of 11 Request for an Amendment to a 1915(c) Home and Community-Based Services Waiver 1. Request Information A. The State of North Carolina requests approval for an amendment to the following Medicaid

More information

Heather Leschinsky Administrator II, Managed Care and HCBS Nebraska Department of Health and Human Services Medicaid and Long-Term Care

Heather Leschinsky Administrator II, Managed Care and HCBS Nebraska Department of Health and Human Services Medicaid and Long-Term Care Heather Leschinsky Administrator II, Managed Care and HCBS Nebraska Department of Health and Human Services Medicaid and Long-Term Care 1 2 Total Medicaid and CHIP population- 235,000 Currently approximately

More information

V Valor: Courage and bravery; Strength of mind and spirit that enables one to encounter danger with firmness

V Valor: Courage and bravery; Strength of mind and spirit that enables one to encounter danger with firmness Purpose The purpose of this policy is to establish departmental and divisional mission statements and values of the Valencia County Emergency Services (VCES). This Directive will also describe, in general

More information

Medicaid Fundamentals. John O Brien Senior Advisor SAMHSA

Medicaid Fundamentals. John O Brien Senior Advisor SAMHSA Medicaid Fundamentals John O Brien Senior Advisor SAMHSA Medicaid Fundamentals Provides medical benefits to groups of low-income people with no medical insurance or inadequate medical insurance. Federally

More information

Application for a 1915 (c) HCBS Waiver

Application for a 1915 (c) HCBS Waiver Application for a 1915 (c) HCBS Waiver HCBS Waiver Application Version 3.3 Submitted by: Connecticut Department of Social Services Patricia A. Wilson Coker, JD, MSW Commissioner Submission Date: October

More information

REPORT OF CORPORATE DIRECTOR RESOURCES AGENDA ITEM: 4

REPORT OF CORPORATE DIRECTOR RESOURCES AGENDA ITEM: 4 CARDIFF COUNCIL CYNGOR CAERDYDD CABINET MEETING: 21 FEBRUARY 2014 CARDIFF COUNCIL HEALTH AND SAFETY POLICY REPORT OF CORPORATE DIRECTOR RESOURCES AGENDA ITEM: 4 PORTFOLIO: CORPORATE Reason for this Report

More information

Reentry Handbook. Copyright 2016 by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). All Rights Reserved.

Reentry Handbook. Copyright 2016 by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). All Rights Reserved. Copyright 2016 by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). All Rights Reserved. CONTENTS NBCRNA Overview....3 Vision 3 Mission.. 3 History 3 Purpose.4 Structure..4

More information

UNIVERSITY PHYSICIANS OF BROOKLYN POLICY AND PROCEDURE

UNIVERSITY PHYSICIANS OF BROOKLYN POLICY AND PROCEDURE UNIVERSITY PHYSICIANS OF BROOKLYN POLICY AND PROCEDURE Subject: COMPLIANCE TRAINING Page 1 of 10 No. HIPAA-11 Original Issue Date Prepared by: Shoshana Milstein Supersedes: Reviewed by: Renee Poncet Effective

More information

SUNY DOWNSTATE MEDICAL CENTER POLICY AND PROCEDURE

SUNY DOWNSTATE MEDICAL CENTER POLICY AND PROCEDURE SUNY DOWNSTATE MEDICAL CENTER POLICY AND PROCEDURE Subject: COMPLIANCE TRAINING Page 1 of 10 No. HIPAA-11 Original Issue Date 02/2008 Prepared by: Shoshana Milstein Supersedes: 09/2013 Reviewed by: Renee

More information

Archives and Records. Finding Aid. COLLECTION NUMBER: MS Coll. 30 Governor s Commission on Gay and Lesbian Youth

Archives and Records. Finding Aid. COLLECTION NUMBER: MS Coll. 30 Governor s Commission on Gay and Lesbian Youth Archives and Records Finding Aid COLLECTION NUMBER: MS Coll. 30 TITLE: Governor s Commission on Gay and Lesbian Youth COLLECTION SUMMARY Creator: Bernie Gardella, Commission Assistant Title: Governor s

More information

ATTACHMENT II EXHIBIT II-C Effective Date: June 1, 2017 CHRONIC DISEASE SPECIALTY PLAN

ATTACHMENT II EXHIBIT II-C Effective Date: June 1, 2017 CHRONIC DISEASE SPECIALTY PLAN ATTACHMENT II EXHIBIT II-C Effective Date: June 1, 2017 CHRONIC DISEASE SPECIALTY PLAN Section I. Definitions and Acronyms The definitions and acronyms in Attachment II, Section I, Definitions and Acronyms

More information

Department of Health and Human Services. Centers for Medicare & Medicaid Services. Medicaid Integrity Program

Department of Health and Human Services. Centers for Medicare & Medicaid Services. Medicaid Integrity Program Department of Health and Human Services Centers for Medicare & Medicaid Services Medicaid Integrity Program California Comprehensive Program Integrity Review Final Report Reviewers: Jeff Coady, Review

More information

Medicaid Home and Community Based Services Waivers

Medicaid Home and Community Based Services Waivers Medicaid Home and Community Based Services Waivers AN INTRODUCTION TO THE WORLD OF MEDICAID HOME AND COMMUNITY- BASED SERVICES AS OF MAY, 2017*** ***subject to change NASDDDS National Association of State

More information

Computer Science Club Constitution

Computer Science Club Constitution version 2.0 Computer Science Club Constitution Contents I) Name of Organization II) Acceptance and Compliance to Registration Requirements and Limitations III) Limits of Registration IV) Annual Re-registration

More information

HOUSE BILL NO. HB0164. Sponsored by: Representative(s) Esquibel, Alden and Tipton and Senator(s) Job and Mockler A BILL. for

HOUSE BILL NO. HB0164. Sponsored by: Representative(s) Esquibel, Alden and Tipton and Senator(s) Job and Mockler A BILL. for 00 STATE OF WYOMING 0LSO-0 HOUSE BILL NO. HB0 Cosmetology act. Sponsored by: Representative(s) Esquibel, Alden and Tipton and Senator(s) Job and Mockler A BILL for AN ACT relating to the Wyoming Cosmetology

More information

Healthcare Service Delivery and Purchasing Reform in Connecticut

Healthcare Service Delivery and Purchasing Reform in Connecticut Healthcare Service Delivery and Purchasing Reform in Connecticut Presentation to National Association of Medicaid Directors November 9, 2011 Mark Schaefer Director, Medical Care Administration Health Purchasing

More information

STATE OF NEW JERSEY GRANT AGREEMENT PROVISIONS BETWEEN THE NEW JERSEY HISTORIC TRUST AND. «General_Mailing_List_Organization» (Grantee)

STATE OF NEW JERSEY GRANT AGREEMENT PROVISIONS BETWEEN THE NEW JERSEY HISTORIC TRUST AND. «General_Mailing_List_Organization» (Grantee) STATE OF NEW JERSEY GRANT AGREEMENT PROVISIONS BETWEEN THE NEW JERSEY HISTORIC TRUST AND «General_Mailing_List_Organization» (Grantee) «Year».«Type»«Order» (Grant Number) GENERAL TERMS AND CONDITIONS...

More information

AGENCY INSTRUCTION. DATE: February 13, 2018

AGENCY INSTRUCTION. DATE: February 13, 2018 MIOSHA Michigan Occupational Safety and Health Administration (MIOSHA) Department of Licensing and Regulatory Affairs (LARA) DOCUMENT IDENTIFIER: MIOSHA-ADM-03-3R4 SUBJECT: AGENCY INSTRUCTION DATE: I.

More information

The Option of Using Certified Public Expenditures as Part of the Medicaid Reimbursement for Florida s Public Hospitals

The Option of Using Certified Public Expenditures as Part of the Medicaid Reimbursement for Florida s Public Hospitals The Option of Using Certified Public Expenditures as Part of the Medicaid Reimbursement for Florida s Public Hospitals Report to the Florida Legislature January 2013 Executive Summary Federal rules allow

More information

EARLY-CAREER RESEARCH FELLOWSHIP GRANT AGREEMENT [SAMPLE Public Institutions]

EARLY-CAREER RESEARCH FELLOWSHIP GRANT AGREEMENT [SAMPLE Public Institutions] Grant Number 200000xxxx EARLY-CAREER RESEARCH FELLOWSHIP GRANT AGREEMENT [SAMPLE Public Institutions] This Grant Agreement ( Grant ) is entered into by and between the Gulf Research Program of the National

More information

9/10/2013. The Session s Focus. Status of the NYS FIDA Initiative

9/10/2013. The Session s Focus. Status of the NYS FIDA Initiative Leading Age NY Financial Manager s Conference, September 10-12, 2013 The Otesaga Resort Hotel, Cooperstown NY Paul Tenan VCC, Inc. FIDA: An Overview and Update The Session s Focus Overview of CMS national

More information

Federal Legislation to Address the Opioid Crisis: Medicaid Provisions in the SUPPORT Act

Federal Legislation to Address the Opioid Crisis: Medicaid Provisions in the SUPPORT Act October 2018 Issue Brief Federal Legislation to Address the Opioid Crisis: Medicaid Provisions in the SUPPORT Act MaryBeth Musumeci and Jennifer Tolbert On October 3, 2018, the Senate overwhelmingly passed

More information

Legislative Report TRANSFORMATION AND REORGANIZATION OF NORTH CAROLINA MEDICAID AND NC HEALTH CHOICE PROGRAMS SESSION LAW

Legislative Report TRANSFORMATION AND REORGANIZATION OF NORTH CAROLINA MEDICAID AND NC HEALTH CHOICE PROGRAMS SESSION LAW Legislative Report TRANSFORMATION AND REORGANIZATION OF NORTH CAROLINA MEDICAID AND NC HEALTH CHOICE PROGRAMS SESSION LAW 2016-121 State of North Carolina Department of Health and Human Services Division

More information

OREGON PRACTITIONER CREDENTIALING APPLICATION (Not an Employment Application)

OREGON PRACTITIONER CREDENTIALING APPLICATION (Not an Employment Application) OREGON PRACTITIONER CREDENTIALING APPLICATION (Not an Employment Application) Prior to completing this credentialing application, please read and observe the following: Healthcare Organizations may contract

More information

ATTACHMENT II EXHIBIT II-C Effective Date: February 1, 2018 HIV/AIDS SPECIALTY PLAN

ATTACHMENT II EXHIBIT II-C Effective Date: February 1, 2018 HIV/AIDS SPECIALTY PLAN ATTACHMENT II EXHIBIT II-C Effective Date: February 1, 2018 HIV/AIDS SPECIALTY PLAN The provisions in Attachment II and the MMA Exhibit apply to this Specialty Plan, unless otherwise specified in this

More information

Medicaid Transformation

Medicaid Transformation JOINT LEGISLATIVE COMMITTEE ON MEDICAID AND NC HEALTH CHOICE Medicaid Transformation Dr. Mandy Cohen, Dave Richard, Jay Ludlam Department of Health and Human Services Nov. 14, 2017 Recap: Where We Are

More information

Managing a High-Performance Medicaid Program

Managing a High-Performance Medicaid Program REPORT Managing a High-Performance Medicaid Program October 2013 PREPARED BY Eileen Griffin and Trish Riley Muskie School of Public Service, University of Southern Maine Vikki Wachino, Consultant to Muskie

More information

``PART A--SAFE AND DRUG-FREE SCHOOLS AND COMMUNITIES. ``This part may be cited as the `Safe and Drug-Free Schools and Communities Act'.

``PART A--SAFE AND DRUG-FREE SCHOOLS AND COMMUNITIES. ``This part may be cited as the `Safe and Drug-Free Schools and Communities Act'. The following is the current text of the Safe and Drug-Free Schools and Communities Act, with amendments proposed in H.R. 284 (formerly H.R. 4776) set forth in bold type: SEC. 401. 21ST CENTURY SCHOOLS.

More information

ALPENA COMMUNITY COLLEGE

ALPENA COMMUNITY COLLEGE ALPENA COMMUNITY COLLEGE Federal Financial Assistance Compliance Audit For The Year Ended June 30, 2011 STRALEY, ILSLEY & LAMP P.C. CONTENTS Page Report on Internal Control over Financial Reporting and

More information

Papua New Guinea: Implementation of the Electricity Industry Policy

Papua New Guinea: Implementation of the Electricity Industry Policy Technical Assistance Report Project Number: 46012 December 2012 Papua New Guinea: Implementation of the Electricity Industry Policy The views expressed herein are those of the consultant and do not necessarily

More information

Request for Proposals

Request for Proposals Skagit County Department of Public Health and Community Services Request for Proposals Youth Recovery Court Treatment Services Skagit County Department of Public Health and Community Services 309 South

More information

Annual Report to CMS Regarding Operation of 1115 Waiver Demonstration Program Year Ending

Annual Report to CMS Regarding Operation of 1115 Waiver Demonstration Program Year Ending Annual Report to CMS Regarding Operation of 1115 Waiver Demonstration Program Year Ending 12.31.13 KanCare Section 1115 Annual Report Demonstration Year: 1 (1/1/2013-12/31/2013) State of Kansas Kansas

More information

Tennessee s Money Follows the Person Demonstration: Supporting Rebalancing in a Managed Long-Term Services and Supports Model

Tennessee s Money Follows the Person Demonstration: Supporting Rebalancing in a Managed Long-Term Services and Supports Model Tennessee s Money Follows the Person Demonstration: Supporting Rebalancing in a Managed Long-Term Services and Supports Model In 2011, Tennessee was awarded a federal Money Follows the Person (MFP) grant,

More information

MEDICAID MANAGED LONG-TERM SERVICES AND SUPPORTS OPPORTUNITIES FOR INNOVATIVE PROGRAM DESIGN

MEDICAID MANAGED LONG-TERM SERVICES AND SUPPORTS OPPORTUNITIES FOR INNOVATIVE PROGRAM DESIGN Louisiana Behavioral Health Partnership MEDICAID MANAGED LONG-TERM SERVICES AND SUPPORTS OPPORTUNITIES FOR INNOVATIVE PROGRAM DESIGN Rosanne Mahaney - Delaware Lou Ann Owen - Louisiana Brenda Jackson,

More information

Maryland Medicaid Program. Aaron Larrimore Medicaid Department of Health and Mental Hygiene May 31, 2012

Maryland Medicaid Program. Aaron Larrimore Medicaid Department of Health and Mental Hygiene May 31, 2012 Maryland Medicaid Program Aaron Larrimore Medicaid Department of Health and Mental Hygiene May 31, 2012 1 Maryland Medicaid In Maryland, Medicaid is also called Medical Assistance or MA. MA is a joint

More information

Louisiana Medicaid Update

Louisiana Medicaid Update Louisiana Medicaid Update HFMA Region 9 Conference November 15, 2015 Origins of Medicaid Means tested entitlement program Established 1965 by Title XIX of the Social Security Act Public health coverage

More information

Managed Long Term Services and Supports (MLTSS)

Managed Long Term Services and Supports (MLTSS) Managed Long Term Services and Supports (MLTSS) Business Process Office of Community Choice Options Hospital and Nursing Facility MLTSS Business Process OCCO June 2014 1 Managed Long Term Services and

More information

Healthcare Referral Program Mutual Patient Care/API

Healthcare Referral Program Mutual Patient Care/API Healthcare Referral Program Mutual Patient Care/API A. Program Goals I. To create the most comprehensive and formal referral program for dental rehabilitation in Northern Arizona II. Create, then expand,

More information

Medicaid and CHIP Payment and Access Commission (MACPAC) February 2013 Meeting Summary

Medicaid and CHIP Payment and Access Commission (MACPAC) February 2013 Meeting Summary Medicaid and CHIP Payment and Access Commission (MACPAC) February 2013 Meeting Summary The Medicaid and CHIP Payment and Access Commission (MACPAC) was established in the Children's Health Insurance Program

More information

EARLY-CAREER RESEARCH FELLOWSHIP GRANT AGREEMENT

EARLY-CAREER RESEARCH FELLOWSHIP GRANT AGREEMENT EARLY-CAREER RESEARCH FELLOWSHIP GRANT AGREEMENT This grant is entered into by and between the Gulf Research Program of the National Academy of Sciences, the Grantor (hereinafter referred to as NAS ) and

More information

BY-LAWS. Current Revision Amended on February per Resolution R50-62 through R50-68

BY-LAWS. Current Revision Amended on February per Resolution R50-62 through R50-68 BY-LAWS Current Revision Amended on February 26 2015 per Resolution R50-62 through R50-68 TABLE OF CONTENTS MISSION STATEMENT, GOALS, VISIONS Pg 3 ARTICLE I. THE GREEN INITIATIVE FUND (TGIF) Pg 4 ARTICLE

More information

Diamond State Health Plan Plus

Diamond State Health Plan Plus I N T E G R A T E D L O N G T E R M Diamond State Health Plan Plus DSHP-Plus C A R E 1115 Demonstration Waiver Diamond State Health Plan (DSHP) Managed Care Delivery System Operational since January 1996

More information

NC TIDE 2016 Fall Conference November 14, Department of Health and Human Services NC Medicaid Reform Update

NC TIDE 2016 Fall Conference November 14, Department of Health and Human Services NC Medicaid Reform Update NC TIDE 2016 Fall Conference November 14, 2016 Department of Health and Human Services NC Medicaid Reform Update Agenda National Medicaid Landscape Medicaid Transformation in NC 1115 Waiver Process NC

More information

QUALITY MANAGEMENT STRATEGY 2015

QUALITY MANAGEMENT STRATEGY 2015 State of Delaware Delaware Health and Social Services (DHSS) Division of Medicaid and Medical Assistance Diamond State Health Plan Diamond State Health Plan PLUS & Children s Health Insurance Program QUALITY

More information

Texas Health Care Transformation and Quality Improvement Program - FAQ

Texas Health Care Transformation and Quality Improvement Program - FAQ Texas Health Care Transformation and Quality Improvement Program - FAQ http://www.hhsc.state.tx.us/1115-faq.shtml 1115 Waiver Approval and Effective Date Why is HHSC seeking an 1115 waiver under the Social

More information

2017 MegaConference ID/DD Waiver and IDD Community Support Program Update

2017 MegaConference ID/DD Waiver and IDD Community Support Program Update Supporting a Better Tomorrow Today 2017 MegaConference ID/DD Waiver and IDD Community Support Program Update 2 CMS Final Rule for Home and Community Based Settings Final Rule effective 3/17/14 Affects

More information