OCTOBER 8, 2015 MFP Monthly Webinar

Goals of our monthly webinars Our goals for our MFP monthly webinars are:  To provide training on key topics  To better the lines of communication between you and us, the MFP staff  To seek feedback on how to better the processes of MFP/waiver services for our participants  To provide the opportunity to share successes and challenges as RTC’s and MFP transitions

MFP Transition Numbers As of today October 8, 2015  160 referrals have been received  54 participants have transitioned to date (15 in 2014 and 39 thus far in 2015) * Our benchmark for 2015 is 47 transitions. * We have met or have exceeded our bench- marks in all waivers except DD and PRTF.

What Services are provided to an MFP participant? Waiver or 1915(i) State Plan Services 0208 (Comprehensive) Waiver Services Big Sky Waiver Services Severe Disabling Mental Illness (SDMI) Waiver Children’s Mental Health Bureau (CMHB) 1915(i) State Plan MFP Demonstration Services are available to participants who enter partner waivers. MFP Demonstration Services are in addition to the core services in partner programs. Note: Demonstration Services could be duplicative. MFP Demonstration Services

Provider billing for MFP Demonstration services All providers must be enrolled Medicaid HCBS providers. All billing for MFP Demonstration Services will be done on a claim form 1500 in the Xerox/MMIS system  DD providers – bill AWACS for waiver services  DD providers – bill MMIS for MFP demonstration services MFP Demonstration Services  Require prior authorization from the MFP Program  Must be supported by the Person Centered Plan MFP Demonstration Services will be paid at actual cost (supporting receipts are required)

MFP Billing and Claims TIE NEEDS TO SERVICE PLAN TIE SERVICES TO COST PLAN CONNECT PROVIDER TO MFP BILLING CODES CONNECT PARTICIPANT TO MFPG SPAN SEND INVOICE/RECEIPTS TO MFP REQUEST PRIOR AUTHORIZATION APPROVAL FILE CLAIM

Successful Transition Story  Robie Pierson-Marcoux with Lewis and Clark County Medicaid Waiver in Helena served as the RTC.  Participant transitioned from a Deer Lodge Health and Rehab nursing home to a subsidized apartment in Helena in July 2015.

Other Items Any ideas … we have an MFP participant in Miles City who is an incomplete quad that is looking to transition from nursing facility to an apartment. The case manager is wanting to provide an power chair and a hospital bed to the participant prior to leaving the facility so he can “practice” with the items. Any ideas on how to fund? Transitions from the Montana State Hospital:  We are in the middle of discussion with AMDD, discharge planners from Warm Springs, Spectrum-Butte case managers, Deer Lodge Rehab facility and MFP to develop a step down process for transitions. MFP participants returning to the institution. Then what?  Participants readmitted to an institution for 30 days or less remain enrolled in Montana’s MFP program. MFP participants remaining in an institution for more than 30 days will be suspended from Montana’s MFP program. The State will reactivate these suspended participants if they transition back out of the institution into the community. These participants do not need to meet the 90-day residency requirement to be reactivated. At this point, individuals upon discharge from inpatient care resume their status as an MFP participant and are eligible to receive MFP services for any remaining days up to the 365- day demonstration participation period.

Next Call … Suggestions for topics that could be discussed in our future webinars? Our next MFP webinar will be Thursday November 12th from 1:30-2:30 p.m.