Wisconsin Department of Health Services Bill Hanna Area Administration Director WHSFMA Conference May 6, 2015 Department of Health Services Fiscal Updates.

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Presentation transcript:

Wisconsin Department of Health Services Bill Hanna Area Administration Director WHSFMA Conference May 6, 2015 Department of Health Services Fiscal Updates

Wisconsin Department of Health Services State Budget Aging & Disability Resource Centers Emergency detention procedures Mental health treatment program consolidation Community Options Program (COP) re-allocation of funding & creation of Children’s Community Options Program (CCOP)

Wisconsin Department of Health Services MH Consolidation & CCOP

Wisconsin Department of Health Services New MH Community Aids Profile 559 – IMD Regular + Profile 571 – IMD OBRA + Profile 501 – CSP Waitlist + Profile 517 – Certified Mental Health Program + Lesser of full COP allocation (profile 367) or actual 2013 COP expenditures for MH/AODA = NEW Mental Health Community Aids * Note this is the Governor’s budget proposal and is subject to change during the budget process

Wisconsin Department of Health Services CCOP Profile 577 – Family Support + Remaining COP funds* (profile 367) after the reallocation to MH community aids = Children’s Community Options Program * This provision only applies to counties not operating a legacy long-term care program (CIP/COP-W). * *Note this is the Governor’s budget proposal and is subject to change during the budget process

Wisconsin Department of Health Services Prepayments DHS will not issue prepayments beginning in 2016 Federal government will not allow DHS to draw federal funds prior to expenditures being reported DHS does not have the budget authority to fund prepayments with GPR

Wisconsin Department of Health Services DHS 1 – Uniform Fee The Secretary has authorized the Department to begin the rule making process to update DHS 1 DHS published a memo dated March 18, 2015 to provide clarity related the DHS uniform-fee-system-memo.pdf 1-uniform-fee-system-memo.pdf o A client must have an established ability to pay before a county can bill or otherwise pursue payment o Inpatient care is subject to ability to pay provisions

Wisconsin Department of Health Services Audit Resolution Team DHS has a new Department wide comprehensive approach to reviewing County audits Super circular places more emphasis on internal controls o Segregation of duties o CARS reports and reconciliations being reviewed o Information technology Other common findings o Proper contract procedures o Purchase of service audits reviewed o Proper claiming and allocation methodologies

Wisconsin Department of Health Services Autism Benefit Changes Federal requires autism services to be provided via Medicaid not a waiver The children’s long term support (CLTS) program will continue to provide other support and services to eligible children Tentative changes will be effective 1/1/16 pending approval from the federal government Sign-up to receive updates via m/updates.htm m/updates.htm

Wisconsin Department of Health Services WIMCR & CCS Reconciliations Trainings scheduled May 18 – CCS cost reporting manual is available: Residential rate setting and billing guidance uidance.pdf 2013 WIMCR pick-up session scheduled May 1 – cost report scheduled June – August

Wisconsin Department of Health Services Income Maintenance Operational Analysis A comprehensive assessment of IM administration across the State Required by the 2015 DHS/IM consortia contract Four phases o Planning (April – May) o Data Gathering (May – July) o Analysis (July – September) o Reporting (September) The project seeks to identify efficiencies gained through the current IM model and share practices supporting efficient IM program operations while maintaining high quality customer service.

Wisconsin Department of Health Services ICD 10 ForwardHealth will require ICD-10 diagnosis codes and ICD procedure codes to be indicated, when applicable, on claim and prior authorization request submissions with dates (dates of service, dates of discharge, requested start dates, etc.) on and after October 1, 2015 The ForwardHealth ICD-10 Code Set Transition Home Page provides FAQs, trainings, references, and resources CD10/ICD10Home.htm.spage#