1. PA School Based ACCESS Program 2013 Statewide Training Sessions www.pcgeducation.com

2. Agenda 2  School-Based ACCESS Program - Changes o PDE Goals – Improved Efficiency & Compliance o CMS Audit – Mandated Changes o Impact of CMS Changes to SBAP Performance o Training & Support  Cost Settlement  Third Party Liability (TPL) Denials  Looking Forward – Optimizing Your Revenue o Revenue Drivers o Reimbursement Estimating Tool o Operational Efficiency – Best Practices

3. SBAP Program Changes 3

4. School-Based ACCESS Program – Changes  PDE – new SBAP program goals o Paperless environment o Enhanced compliance-checks  EasyTrac Web-based & paperless system Exception reports (compliance) Monthly Management Reports 4

5. School-Based ACCESS Program – Changes  PDE – new SBAP directions o Paperless environment o Enhanced compliance-checks  CMS audit – mandated changes o New time study methodology o Voluntary time study now mandatory o Budget costs no longer accepted o Now, must provide actual costs, quarterly o New annual cost reconciliation  EasyTrac Web-based & paperless system Exception reports (compliance) Monthly Management Reports  RMTS - Random Moment Time Study  MCRCS – Medicaid Cost Reporting & Claiming System  Cost Settlement 5

6. School-Based ACCESS Program – Changes  New SBAP policies  New software (EasyTrac)  New web-based systems (RMTS, MCRCS)  New business processes (Cost Settlement) MEAN TWO THINGS…  TRAINING  CUSTOMER SUPPORT  EasyTrac Web-based & paperless system Exception reports (compliance) Monthly Management Reports  RMTS - Random Moment Time Study  MCRCS – Medicaid Cost Reporting & Claiming System  Cost Settlement 6

7. Onsite Training  EasyTrac trainings mid-July and August 2012  Over 900 people attended 35 initial onsite sessions (July- August 2012)  Over 450 people attended 16 additional onsite sessions (Sept - Oct – Nov 2012)  Statewide PaTTAN sessions - late August, 2012  Over 1,000 people attended 3 onsite sessions  Statewide PDE/DPW sessions - November, 2012  Over 600 people attended 6 onsite sessions 7

8. Live WebEx Training (Sept, Oct, Nov 2012)  EasyTrac training Trained over 1,200 people in 61 sessions  Data Upload training Trained over 580 people in 20 sessions  RMTS Overview training Trained over 245 people in 4 sessions  RMTS Administrator training Trained over 620 people in 4 sessions 8

9. WebEx Training  From August 2, 2012 to July 3, 2013 o 142 Live WebEx Presentations o 3,221 registered individuals  Recorded WebEx training on SBAP website (available 24x7) o EasyTrac Administrator o EasyTrac User (PCA, Nurse, and Speech) o Data Import o RMTS Overview o RMTS Administrator o MCRCS o SBAP Overview for Early Intervention 9

10. Live WebEx Training (August, Sept, 2013) Weekly live webex training sessions  EasyTrac Administrator training  EasyTrac User training  Exception Reports training  Monthly Management Reports training Intensive scheduling of training sessions (as needed)  MCRCS training  MCRCS Q&A sessions  RMTS training  RMTS Q&A sessions 10

11. Customer Support  Customer Support Volumes:  Service level goal: return call or email within 48 hours (2 business days)  FY13: 5,000+ customer contacts (phone & emails) per month  Some weeks, activity spikes to 2,500 customer contacts, per week  Customer Support channels:  PA SBAP Website: www.publicconsultinggroup.com/client/paaccesswww.publicconsultinggroup.com/client/paaccess  Toll free #: 866-912-2976  SBAP questions & support: SBAPsupport@pcgus.comSBAPsupport@pcgus.com  EasyTrac questions & issues: EasyTrac Message Board (secure email) 11

12. Impact of Mandated CMS Changes 12

13. CMS Mandated Changes that Impacted Performance Elimination of reimbursement for o IEP meetings o Collateral services Overhead capped at 25% o Reduction in Billing Rates o Reduction in Medicaid Administrative Claims 13

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16. 16 -15% If collateral services were 15% of total service units in FY12, then, without them the total FY12 service units would have been 16,830,000

17. 17 If collateral services were 25% of total service units in FY12, then, without them the total service units would have been 14,850,000

18. Statewide Performance How did participating schools do? 18

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20. Despite CMS mandates that apply equally to ALL participating SBAP schools… 20

21. Despite CMS mandates that apply equally to ALL participating SBAP schools… FY13 performance among participating schools varied with some experiencing better results than others in a challenging year 21

22. Individual School Performance 22

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39. FY13 Cost Settlement 39

40. Cost Settlement timeline for 2012-13 Detailed training begins Sept, Oct 2013 Cost Settlement process closes Jan, 2014 Cost Settlement financial close-out March, 2014 SBAP Performance for FY13 will not be finalized until Cost Settlement has been completed 40

41. O CTOBER TO D ECEMBER – Q UARTER 1 J ANUARY TO M ARCH – Q UARTER 2 J ULY TO S EPTEMBER – Q UARTER 4 PA SBAP 2013-2014 Deadlines PA School Based ACCESS Program Fiscal Year Quarterly Financials Q3 July 1 st - Aug 1 st New Rosters/Calendars August 30 th Roster Certifications Q1 September 9 th October to December Quarterly Financials Q4 October 1 st - November 1 st Roster Certifications Q2 December 10 th Annual Cost Report Opens (FY 13 ) TBD Quarterly Financials Q1 January 2 nd - February 2 nd Roster Certifications Q3 March 10 th Annual Cost Report Certification (FY 13) TBD A PRIL TO J UNE – Q UARTER 3 Quarterly Financials Q2 April 1 st - May 1 st

42. TPL Denied Claims – Update 42

43. Third Party Denials – Efforts to Turn Off the Edit Initial letter sent to 136 insurance companies in July, 2012 then August, 2012 Phone and email follow-up ZERO responses Same letter sent to 136 insurance companies in July, 2013 Phone and email follow-up 16 “denial” responses Sent second version of letter to 120 insurance companies August, 2013 Phone and email follow-up 12 “denial” responses Sent third version of letter to 108 insurance companies September, 2013 3 “denial” responses  Executive level initiatives 43

44. Looking Forward Optimizing SBAP Program 44

45. PA SBAP -- Optimizing Your Performance  What’s important? o Capture services on a timely basis, making sure they are fully documented in EasyTrac with all necessary compliance data o Capture all appropriate actual costs incurred o Ensure that all allowable/eligible and appropriate staff are included in RMTS rosters o Estimate service log and reimbursement amounts 45

46. Estimating FFS Reimbursement 46

47. Estimating FFS Reimbursement 47 Enter Your ANNUAL DATA once

48. Estimating FFS Reimbursement 48 Enter Your SCENARIO DATA Here Estimated Revenue Here Get Your

49. PA SBAP -- Optimizing Your Performance  Operational Efficiency o Establish a timely submission policy for entering service log data  Service Providers  ACCESS Coordinators (On Behalf Of)  Third party vendors o Use the Service Documentation Review Report to ensure service providers are entering service logs on a timely basis o ACCESS Coordinators should review & approve logs frequently o Aggressively manage Exception Reports 49

50. PA SBAP -- Optimizing Your Performance  Use EasyTrac Reports o EasyTrac standard reports will help you manage your SBAP activities and improve cashflow o The Active Student Extract Report will show the following Medicaid required Compliance data :  Primary Disability  IEP Dates  PA Secure ID  Parental Consent Dates 50

52. Back-up Slides 52

53. Third Party Liability Denials – as of 9/19/2013 Statewide Total TPL denials – $21,945,709 (gross dollars) TPL denials for all IU’s (above) – $9,293,527 (gross dollars) 53

54. New process going forward entails the cost reconciliation ensuring providers (districts) are not reimbursed more than their allowable costs While the exact PA formula may vary, here is a sample calculation: Cost Settlement: Sample Calculation Allowable costs x Time study results x Medicaid eligibility rate x FFP = Reimbursable Costs eg., Salaries, Indirect costs x Direct Service % x Spec Ed students on Medicaid x Approx 54% = $Total amount $100,00050%35%54%$9,450 > www.education.state.pa.us

55. RMTS >> MCRCS >> Cost Settlement 55

56. 56 Unofficial “life cycle” of service logs

57. PCG Contacts 57