CBHDA Small Counties Strategic Planning Meeting Operationalizing the Medicaid Managed Care Final Rule May 18, 2017

Presentation Outline Review of significant 2017 and 2018 provisions Developing a Final Rule/contract compliance work plan Tools and resources, strategies for implementation, and next steps Funding for MHP implementation in the State Budget FY 2017-18 May Revision

Review of significant 2017 and 2018 provisions

Provisions Effective July 1, 2017 Information Requirements State Monitoring Requirements Beneficiary Protections Program Integrity Health Information Systems Coverage & Authorization Mental Health and Substance Use Disorder Parity – October 2, 2017 To include a bit more detail on which sections fall under these categories

Specific 2017 Deliverables Uniform Provider Credentialing Policy Indian Enrollee Claiming and Service Requirements Enrollee/Beneficiary Handbook Notice of Adverse Benefit Determinations Subcontractor Guidance MHP Accreditation Status, if applicable Ownership and Control Reporting Requirements Encounter and Financial Audit Requirements Annual Report of Overpayment Recoveries Reporting and Data Certification Procedures Web Transparency and Information Requirements

Provisions Effective July 1, 2017

Provisions Effective July 1, 2018 Network Adequacy Screening & Enrollment Encounter Data Beneficiary Support System Quality Strategy Transition Plan EQR Requirements To include a bit more detail on which sections fall under these categories

Provisions Effective July 1, 2018

Provisions Effective after 2018 Annual Program Assessment Reports Quality Rating System To include a bit more detail on which sections fall under these categories

Provisions Effective After July 1, 2018

Developing a Final Rule/ contract compliance work plan

Final Rule & Contract Compliance Work Plan Overview of the MHP contract crosswalk Key changes to the organization and structure of the MHP contract Aligning the contract with new 42 CFR Part 438 requirements Overview of the CMS Guide to Contract Approval

Final Rule & Contract Compliance Work Plan What should counties do first when developing a Final Rule compliance work plan? How can counties utilize the MHP contract crosswalk and/or the CMS Guide to Contract Approval to inventory, update, or develop new policies and procedures?

strategies for implementation and next steps

Strategies for Implementation Other tools and templates for counties: Key provisions by timeline document High-level document Can be organized by category or implementation date Template MHP work plan Detailed action plan Use to plug in action steps from MHP contract crosswalk or CMS Guide to Contract Approval document

Strategies for Implementation: Discussion How can small counties use the resources and tools shared today to plan for implementation? How will counties organize the work locally? What could a regional approach look like? How can small counties share resources? What are small county needs? What are next steps?

Proposed fy 2017-18 state budget

Funding for MHP Implementation The proposed state budget recognizes the State’s Proposition 30 obligations For new federal requirements, the state is responsible for funding 50% of the non-federal share of costs (25% of total costs) Counties will be responsible for the other half of the non-federal share (25% of total costs)

Estimated FY 17-18 Costs for MHP Implementation of the Managed Care Regulations* *Source: DHCS Medi-Cal Estimate May 2017, Other Administrative Policy Change Number 112

CBHDA Budget Advocacy http://www.cbhda.org/wp-content/uploads/2014/12/1704_FY-17-18-Budget-Memo-Support-for-MHP-Implementation-of-MMC-Regs_Final_42017.pdf

Conclusion Final questions and reflections

Contact Information CBHDA Contact: Linnea Koopmans, Senior Policy Analyst lkoopmans@cbhda.org 916-556-3477 x6018 DHCS Contact: Autumn Boylan, Acting Assistant Division Chief Autumn.Boylan@dhcs.ca.gov 916-322-1730