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

2. 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 May Revision

3. Review of significant 2017 and 2018 provisions

4. 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

5. 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

6. Provisions Effective July 1, 2017

7. 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

8. Provisions Effective July 1, 2018

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

10. Provisions Effective After July 1, 2018

11. Developing a Final Rule/ contract compliance work plan

12. 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

13. 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?

14. strategies for implementation and next steps

15. 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

16. 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?

17. Proposed fy 2017-18 state budget

18. 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)

19. 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

20. CBHDA Budget Advocacy

21. Conclusion
Final questions and reflections

22. Contact Information
CBHDA Contact:
Linnea Koopmans, Senior Policy Analyst
x6018
DHCS Contact:
Autumn Boylan, Acting Assistant Division Chief