financial management services agency quarterly …2017/05/25 · financial management services...
TRANSCRIPT
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Financial Management Services Agency Quarterly Technical Assistance Webinar
Consumer Directed Services Medicaid/CHIP Division May 2017
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Agenda
• Introduction and Welcome • Texas Medicaid Healthcare Partnership Enrollment • Update from Texas Council on Consumer Direction Chair • Navigating the Consumer Directed Services Website • Discussion: Budget Workbooks • Processing Transfers • Financial Management Services Agency (FMSA) Contract
Compliance and Performance Management • Consumer Directed Services staff reminders • FMSA Q & A
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Texas Council on Consumer Direction Nancy Crowther, Council Chair
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Texas Medicaid Healthcare Partnership (TMHP) Enrollment Lisa Cruz Hidrogo, Special Projects Manager
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Provider Enrollment • Health and Human Services Commission is using a
manual enrollment process for providers that currently have APIs assigned until an automated process is available at TMHP for MCO LTSS providers.
• Providers assigned an Atypical Provider Identifier (API)must complete managed care organization (MCO) long-term services and supports (LTSS) provider enrollment process no later than January 1, 2018.
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Provider Enrollment (page 2) • Providers not enrolled by the deadline may be
unenrolled from the MCO LTSS program • FMSAs can enroll through TMHP and must do so
before January 1, 2018 • Additional information will be provided regarding
the transition from manual to automated process
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Provider Enrollment (page 3) • Request enrollment, get application status, submit
questions or concerns to [email protected] • Request by include:
• Providers business name, • Tax identification number • National provider identifier
• Question and answer document is being prepared for distribution which provides additional information regarding the process
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Navigating the Provider CDS Website https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/consumer-directed-services-cds
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Navigating the Provider CDS Website
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Navigating the Provider CDS Website
• CDS Option Webinars • FMSA Quarterly Technical Assistance Webinars
• Forms and Handbooks • Consumer Directed Services Option Handbook • Budget Workbooks • Sample forms for employers
• Training Opportunities • CDS Support Advisor Certification Computer-based
Training (CBT) • Training Presentations
• Internal Revenue Service (IRS) sample forms • CARE billing
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Navigating the CDS website https://hhs.texas.gov/services/disability/consumer-directed-services
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Navigating the CDS website
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Navigating the CDS website (page 2) • Service Delivery Option
• Agency Option • Employer Option (CDS) • Service Responsibility Option
• Employer Resources • Consumer Directed Services Option Employer
Manual • PDF Document of Roles and Responsibilities
• Using an Unlicensed Employee to Perform Nursing Tasks
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Processing Transfers
Texas Administrative Code (TAC) §41.403
• An individual's FMSA must process a request by the individual or legally authorized representative (LAR) to transfer from one FMSA to another FMSA in accordance with transfer procedures and requirements of the individual's program.
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Processing Transfers
Transferring FMSA Responsibility
Transferring FMSA is responsible for: • Accounting for funds allocated in service plan and budgets
• Bill for funds in the budget that the FMSA must pay • Make payments within required time frames • Submit billing adjustments for prior claims and payments
• Notifying the employer and case manager/service coordinator (CM/SC) of the number of units and amount of funds remaining in budget after scheduled transfer
• Transferring all employer-related and employer-agent related information and reports to receiving FMSA at transfer
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Transferring FMSA Responsibility (page 2) Transferring FMSA is responsible for:
• Distributing a final FMSA report to employer, Designated Representative (DR), CM/SC, and receiving FMSA within 5 working days after the transfer
• Submit a satisfaction survey to employer or DR
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Processing Transfers
CM/SC responsibilities • Within 5 working days of the receipt of a request to
transfer, the CM/SC must: • Process the individual’s request to transfer according to
program rules • Calculate the number of units or amount of funds needed to
complete the service plan period • Revise the service plan to indicate number of units or
amounts of funds • Approve the units and funds calculated to complete the service
period • Provide copy of transferring service plan to receiving FMSA and
employer • Provide copy of the individual’s revised service plan to
transferring FMSA, receiving FMSA and employer or DR
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Processing Transfers
Receiving FMSA Responsibilities
Receiving FMSA is responsible for: • Enrolling the individual and employer with FMSA
including registering the FMSA as the employer-agent • Initiating FMS and employer-agent responsibilities
including • Conducting an initial orientation • Entering in the required service agreement with
employer • Obtain required service agreements with each of
the employer’s service providers
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Processing Transfers
Employer/DR responsibilities
Employer/DR must: • provide documentation to receiving FMSA
within five working days, • maintain eligibility of each current
employee; and • provide other documentation requested by
receiving FMSA
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Contract Compliance and Performance Management
Patricia Herrin, CDS Contract Specialist
• List of Excluded Individuals/Entities (LEIE) policies and procedures to include missing elements
• Documentation for quarterly reports sent to employer and CM/SC
• Written approval of budget prior to initiation of services and budget revisions
• Completing Forms
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Contract Compliance and Performance Management Craig Williamson, Financial Analyst
• Obtaining Employer Identification Number (EIN) & Taxpayer Identification Number (TIN) before accepting transfers
• Completing Forms 1730 or Form W-4 when changes occur
• Using the effective Texas Workforce Commission (TWC) tax rate for the budget year
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CDS Staff Reminders • Budget Issues:
• Bonuses must be reflected in the appropriate section of the budget
• The CDS budget is based on the authorized service plan. The hours (or units) entered MUST match the units allowed for that particular service in the service plan.
• Form Updates • Technical Assistance Webinars are mandatory, sign in
with contracted entity name • Send training requests to CDS inbox at
[email protected] • Make sure your agency is signed up for GovDelivery at;
https://service.govdelivery.com/accounts/TXHHSC/subscriber/new?topic_id=TXHHSC_65
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Questions and Answers [email protected]