CMAA Site Visit Guidelines & Requirements Presenters

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Presentation transcript:

CMAA Site Visit Guidelines & Requirements Presenters Lynda Wheeler, Lake County Frank Solem, Marin County La Valda Marshall, Marin County The purpose of DHCS audits, how audits are conducted, what is reviewed, how the LGA should prepare, and common findings. LGA Annual Conference, April 2017

LGA Annual Conference, April 2017 AGENDA CMAA Process Flow Site Review Experience Lake County (Desk Review) Marin County (Site Visit) Site Visit Guidelines Requirements Resources (Hyperlinks) S I TE V I S T LGA Annual Conference, April 2017

SITE VISIT PROCESS FLOW CMAA Engage Review Exit Report S I TE V I S T LGA Annual Conference, April 2017

LAKE COUNTY (Desk Review) Marin County (Site Visit) Experiences CMAA Lake County (Desk Review) Before DHCS FYI to County Engagement Letter County Organizes & review documents Send the documents to DHCS During Checklist, Unit Tool, and Interview Questions as guide. Email/Calls for request/clarification Email deliverables by due date Phone calls for clarification After Continue Reviewing documentation Phone Exit Conference Issue Report open communication/no finding surprises Receive and respond to report within 45 – 60 days. Corrective Action Plan Marin County (Site Visit) Before DHCS FYI to County Engagement Letter County Organizes & review documents Send the documents to DHCS During Checklist, Unit Tool, and Interview Questions as guide. On site request/clarification Site Review Binder & other docs Ongoing conversations with DHCS After Review & Request documents Pre Report Stage Continue to provide documents Awaiting report S I TE V I S T LGA Annual Conference, April 2017

LGA Annual Conference, April 2017 GUIDELINES CMAA Site Visit Purpose/Goals Ensure Compliance With State and Federal Laws, rules, and regulations Satisfy Contract Requirements Satisfy Medicaid State Plan requirements S I TE V I S T LGA Annual Conference, April 2017

LGA Annual Conference, April 2017 GUIDELINES CMAA Site Visit Frequency On-site or Desk Review Every 4 years Technical Assistance Every 2 years (upon request) S I TE V I S T LGA Annual Conference, April 2017

GUIDELINES PROCESS FLOW CMAA Engage Review Exit Report S I TE V I S T LGA Annual Conference, April 2017

LGA Annual Conference, April 2017 GUIDELINES CMAA Document – 1 of 3 Documentation Checklist (See Handout) Contracts and/or MOU Claiming Plan Certified Public Expenditure (CPE) Time Survey Invoice S I TE V I S T LGA Annual Conference, April 2017

CHECKLIST (Hyperlink and Example) CMAA http://www.dhcs.ca.gov/provgovpart/Documents/ACLSS/CMAA/Site%20Visit/CMAA%20Site%20Visit%20Documentation.pdf S I TE V I S T LGA Annual Conference, April 2017

LGA Annual Conference, April 2017 GUIDELINES CMAA Document – 2 of 3 DHCS Unit Tool Contracts and/or MOU Response: Yes, No, or N/A Claiming Plan Certified Public Expenditure (CPE) Time Survey Invoice S I TE V I S T LGA Annual Conference, April 2017

UNIT TOOL (Hyperlink and Example) CMAA www.dhcs.ca.gov/provgovpart/Pages/CMAASiteVisitTools.aspx S I TE V I S T LGA Annual Conference, April 2017

(Hyperlink and Example) GUIDELINES CMAA Document – 3 of 3 Interview Questions (Examples-See Handout) (Hyperlink and Example) www.dhcs.ca.gov/.../CMAA/.../ CMAA%20Site%20Visit%20Interview%20Questions.pdf S I TE V I S T LGA Annual Conference, April 2017

LGA Annual Conference, April 2017 REQUIREMENTS CMAA SITE VISIT - ENGAGEMENT FYI Email from DHCS Analyst Engagement Letter from DHCS Analyst (How) Email to County (When) At least 60 Days prior to visit (What) Identifies Calming Units (What) Identifies Staff to Interview (What) Date and Time of Site Visit (What) Site Visit Address (What) Fiscal Years under review S I TE V I S T LGA Annual Conference, April 2017

LGA Annual Conference, April 2017 REQUIREMENTS CMAA SITE VISIT – REVIEW/EXIT DHCS Analyst receives Site Visit Review Binder DHCS Performs Site Review using review tools Site Visit Checklist Site Visit Unit Tool Site Visit Survey Participant DHCS/County have Exit Conversation Site review status (compliance update) Pending Deliverables Other Open Issues Note: < 30 days to resolve prior to report S I TE V I S T LGA Annual Conference, April 2017

LGA Annual Conference, April 2017 REQUIREMENTS CMAA SITE VISIT – REPORT DHCS 30 Days after the Site Visit Send Summary of Finding Report Documentation or claiming issues Items requiring corrective action Deadlines to address all findings Indication corrective actions are not necessary Notice of compliance and closure S I TE V I S T LGA Annual Conference, April 2017

LGA Annual Conference, April 2017 RESOURCES CMAA Department of Health Care Services website: www.dhcs.ca.gov CMAA website: www.dhcs.ca.gov/provgovpart/Pages/CMAA.aspx LGA Consortium website: www.maa-tcm.com S I TE V I S T LGA Annual Conference, April 2017

LGA Annual Conference, April 2017 CMAA S I TE V I S T LGA Annual Conference, April 2017