medicaid/education reports

Medicaid/Education Reports

August 8-9, 2012

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Random Moment Time Studies

Inappropriate Responses to RMTSExample 1: (Would not be coded as Medicaid allowable cost. Needs more detail.)

1. Who was with you?• No one

2. What were you doing?• Duty

3. Why were you doing this activity?• Assigned duty

4. Is this activity regarding a Special Education student?• No

Inappropriate Responses to RMTSExample 2: 1. Who was with you?

• A group of people charged with carrying out the work of an establishment

2. What were you doing?• Inputting the last “moment in time” documentation

instead of using my scheduled paperwork time to prepare for the two IEPs that I have next week.

3. Why were you doing this activity?• You keep sending me these “moments.” I am itinerant

and MCS will not provide me with a computer, IPad, or other internet access to use during treatment blocks of time. Scheduled office time is the only time I can complete these “moments.”

4. Is this activity regarding a Special Education student?• NA

Preliminary Results of 1st RMTSFebruary - March

Response rates – 85% required (3000 moments per “pool”)

» 92.13% - Direct Services» 83.20% - Care Coordination» 78.60% - Personal Care» 89.47% - Admin

PCG’s Time Study Team – “less than appropriate responses were submitted.”

A number of inappropriate responses were received by staff participating in the RMTS.

Two areas of concern:

• Incomplete responses• Rudeness/Frustration

Preliminary Results of 1st RMTSFebruary - March

Service percentages responses

» 49.16% - Direct Services» 4.24% - Care Coordination» 20.21% - Personal Care

Cost Settlement Calculation Example – Neutral

WV: Introduction to Medicaid Cost Based School Based Health Services 40

1.0 Total Costs of Eligible SBHS Provider Costs (county’s cost) $1,000,000

2.0 Indirect Cost Rate 115.00%

3.0 Total Costs of Eligible SBHS Provider Costs $1,150,000

4.0 RMTS Direct Medical Percentage Results (Statewide results) 65.00%

5.0 Direct Medical Services Costs $747,500

6.0 Application of Medicaid Eligibility Rate (IEP Ratio) (county’s) 50.00%

7.0 Medicaid Direct Medical Services Costs (for the county) $373,750

8.0 Medicaid Interim Payments Received (by the county) $373,750

9.0 Medicaid Cost Settlement (at the end of the year – July 2013) $0

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