3. 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

4. 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 2015 - School Based Services Conference3

5. 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 2015 - School Based Services Conference4

6. 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 2015 - School Based Services Conference5

7. SBS Website From http://michigan.gov/mdch select Providershttp://michigan.gov/mdch August 2015 - School Based Services Conference6

8. Select Providers August 2015 - School Based Services Conference7

9. Select Medicaid August 2015 - School Based Services Conference8

10. Select Billing and Reimbursement August 2015 - School Based Services Conference9

11. Select Provider Specific Information August 2015 - School Based Services Conference10

12. Select School Based Services August 2015 - School Based Services Conference11

13. SBS Website & Databases August 2015 - School Based Services Conference12

14. MI SBS Conference Presentations August 2015 - School Based Services Conference13

15. MAER & MAER Instruction Section August 2015 - School Based Services Conference14

16. RMTS Section August 2015 - School Based Services Conference15

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

18. The PCG Claiming System ISD/LEA Coordinators now use one system for all of the following: August 2015 - School Based Services Conference17 Staff Pool ListsCalendars Random Moment Time Study Quarterly Financials

19. Accessing the PCG Claiming System https://claimingsystem.pcgus.com/mi August 2015 - School Based Services Conference18

20. Navigating the PCG Claiming System August 2015 - School Based Services Conference19 1 2 34 5 1.Quarter Dropdown 2.ISD/LEA Menu 3.Access the Staff Pool List 4.Access the Calendar 5.Access Quarterly Financials

21. Questions? August 2015 - School Based Services Conference20

22. Contact us miaop@pcgus.com 877-395-5017 August 2015 - School Based Services Conference21

23. Resources For SBS Providers Amy Kanter Michigan Department of Community Health Hospital & Clinic Reimbursement Division kantera@michigan.gov 517-373-4522

24. 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

25. Medicaid Provider Manual

26. 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

27. Medicaid Policy Bulletins

28. Provider “L” Letters

29. 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 emails View on your desktop computer, smart phone, tablet

30. 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

31. 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

32. 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

33. Parental Consent - Arabic

34. QUESTIONS Thank You!

35. CONTACTS Policy Kevin Bauer, MDCH 517-241-8398 bauerk2@michigan.gov Cost Reporting and Cost Settlement Amy Kanter, MDCH 517- 373-4522 kantera@michigan.gov Office of Audit John Lambert, MDCH 517-335-4792 lambertj4@michigan.gov