Schools and Medicaid Quarterly Call March 6, 2019

Introductions - AHCA and FDOE/SSS staff Agenda Introductions - AHCA and FDOE/SSS staff FFS Updates and Q and A from districts SDAC AHCA Monitoring AAC concurrence SB290/ H587 Anne-Start Introductions-self, TJ, Richard AHCA headquarters staff (if any other than Luc) Jeffrey-Monitoring staff

Call Reminders Put your name and district or company represented in chat box Phone lines will be muted during most of call, so enter questions in chat box If you have questions as the meeting progresses, please enter them into the chat box. We will pause periodically during the call to answer questions. Anne/TJ

Fee-for-Service AAC services: Billing and IEP FFS reimbursement reports on AHCA website (status of updating) Behavioral evaluations performed prior to development of IEP (answer from previous call) Provider credentials/title in documentation

Fee-for-Service-District Questions Is the reduction of billable units as reflected in the January 2019 fee schedule and our claim denials final? Is billing allowed for a therapy (SL/OT/PT) evaluation when the outcome is that the student does have an IEP, but does not have SL/OT/PT services on the IEP?

FFS-Questions from Districts When can charter schools begin billing for services? If charter schools want to participate in the school-based program, where should we direct them to get assistance in enrolling and billing? Telemedicine-Is the GT modifier in the system so that districts can bill for service provided through telemedicine?

FDOE: AAC Concurrence Entities presenting forms to districts to sign Medicaid requires that school districts concur with the AAC device being proposed (for students under age of 21 and in public school) There is no additional guidance, so how district handles is a district decision

SDAC Matching titles: attestation will be required beginning Q2 2019 Removing examples from forms and systems beginning Q2 2019 7 day response time (paper or electronic) beginning Q2 2019 Student names in sample responses Invalid response: outside of school hours “Scheduling”- when is it code 5 and when is it code 10? Code 11 vs. code 12 Code 12 vs. code 13 Payroll submission Sample Pool

AHCA Monitoring Update New Monitoring Tool language/design beginning Q2 2019 Administrative Claiming (SDAC) Medicaid Certified School Match (MCSM) Annual Fee-for-Service (MCSM) Monitoring Documentation checklist/monitoring tools Organization Turnaround time

SB290/H587 SB 290 and H 587 are identical bills Current: Florida Statute allows for school districts, private schools and charter schools to seek Medicaid reimbursement for services provided under an IEP or IFSP and to certify match for these services. Allows for alignment with Medicaid SPA, allowing for districts, private and charter schools to seek Medicaid reimbursement and certified match per upcoming rule for services outside of the IEP/IFSP Amends 409.9071, F.S.: deletes requirement that certified funds are available only for services to students with IEPs/IFSPs Amends 409.9072, F.S.: deletes requirement that Medicaid reimbursement is only available for services provided to students with IEPs/IFSPs Provides effective date of July 1, 2019 Current status: 1/25/19: SB referred to Education, Health Policy and Appropriations 2/6/19: HB referred to Health Market Reform Subcommittee, Health Care Appropriations Subcommittee, Health and Human Services Committee.

AHCA Contact Information Ami Flanigan-School district administrative claiming, transportation rates Martin Fanburg-Policy Leila Jett-Monitoring Ami.Flanigan@ahca.myflorida.com Martin.Fanburg@ahca.myflorida.com Leila.Jett@ahca.myflorida.com Anne

FDOE Contact Information Anne Glass-FDOE liaison with AHCA, school districts Thomas Garrett-PEER, Medicaid Tracking System 3.0 Richard Gary-EMACS, Medicaid Tracking System 2.0 Anne.Glass@fldoe.org Thomas.Garrett@fldoe.org Richard.B.Gary@gmail.com Anne