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

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 School Based Services Conference3

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 School Based Services Conference4

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 School Based Services Conference5

SBS Website From select Providershttp://michigan.gov/mdch August School Based Services Conference6

Select Providers August School Based Services Conference7

Select Medicaid August School Based Services Conference8

Select Billing and Reimbursement August School Based Services Conference9

Select Provider Specific Information August School Based Services Conference10

Select School Based Services August School Based Services Conference11

SBS Website & Databases August School Based Services Conference12

MI SBS Conference Presentations August School Based Services Conference13

MAER & MAER Instruction Section August School Based Services Conference14

RMTS Section August School Based Services Conference15

Short Overview of the New RMTS System 2015 School-Based Services Conference August 17-18, 2015

The PCG Claiming System ISD/LEA Coordinators now use one system for all of the following: August School Based Services Conference17 Staff Pool ListsCalendars Random Moment Time Study Quarterly Financials

Accessing the PCG Claiming System August School Based Services Conference18

Navigating the PCG Claiming System August School Based Services Conference Quarter Dropdown 2.ISD/LEA Menu 3.Access the Staff Pool List 4.Access the Calendar 5.Access Quarterly Financials

Questions? August School Based Services Conference20

Contact us August School Based Services Conference21

Resources For SBS Providers Amy Kanter Michigan Department of Community Health Hospital & Clinic Reimbursement Division

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

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 s 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!

CONTACTS Policy Kevin Bauer, MDCH Cost Reporting and Cost Settlement Amy Kanter, MDCH Office of Audit John Lambert, MDCH