financial management services agency quarterly …2017/05/25 · financial management services...
TRANSCRIPT
Financial Management Services Agency Quarterly Technical Assistance Webinar
Consumer Directed Services Medicaid/CHIP Division May 2017
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
Texas Council on Consumer Direction Nancy Crowther, Council Chair
Texas Medicaid Healthcare Partnership (TMHP) Enrollment Lisa Cruz Hidrogo, Special Projects Manager
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.
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
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
Navigating the Provider CDS Website https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/consumer-directed-services-cds
Navigating the Provider CDS Website
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
Navigating the CDS website https://hhs.texas.gov/services/disability/consumer-directed-services
Navigating the CDS website
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
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.
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
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
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
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
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
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
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
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
Questions and Answers [email protected]