VFCA Managed Care Readiness Funds

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January 20, 2016

(revised 1/26/16)


Agenda

  • Change in Payment Processes for Managed Care Readiness Funds
  • Allowable Expenses and Reporting
  • Next Steps

Readiness Payments will be processed through the Foster Care Per Diem

  • All payments for the Managed Care Readiness funds will be processed through the eMedNY system as a rate add on to the current Foster Care Per Diem
  • This rate add on will be in effect from 11/1/15 to 3/31/16
  • Rate add on = VFCA's approved contract amount / estimated care days over the period 11/1/13 to 3/31/14
  • Each agency's allocation amount has not changed
  • Using rate add on to Foster Care Per Diem will streamline and expedite payment of your readiness funds
    • Agencies will not have to submit vouchers

Readiness Payments will be processed through the Foster Care Per Diem - Agencies that currently bill the Per Diem

  • Agencies that currently bill the Foster Care Per Diem will continue to follow the current process for submitting claims - there are no changes to the process
  • When the rate package is approved and processed, these agencies will receive retroactive payments going back to November 1, and depending on date of approval, prospective payments through 3/31/16

Readiness Payments will be Processed through the Foster Care Per Diem Agencies that DO NOT bill the Per Diem

  • According to the Department's information, there are currently 19 agencies that do not bill the Foster Care Per Diem
  • 2 of these agencies only have MMIS number for B2H and they will need to apply for a NPI number and a new MMIS number
  • 8 of these agencies do not have a MMIS number and will need to enroll in the NYS Medicaid Program, some may need to apply for a new NPI number
  • 2 of these agencies have an inactive MMIS number, and will have to submit a reactivation application https://www.emedny.org/info/ProviderEnrollment/child_foster_care/index.aspx
  • The remaining 7 agencies will be able to submit claims when the rates are approved and when they receive notification from DOH
  • The Department will provide agencies without an MMIS number with additional assistance on how to obtain one
  • Information on the enrollment process can be found at: https://www.emedny.org/info/ProviderEnrollment/child_foster_care/index.aspx

Next Steps for Agencies that DO NOT bill the Per Diem

  • Any agency that does not have an MMIS and/or NPI number must obtain these as soon as possible
  • Any agency that has an inactive MMIS number must complete the reactivation process as soon as possible
  • The Department will schedule a separate webinar to provide further guidance to the 19 agencies that do not currently bill the Foster Care Per Diem
  • The webinar will provide details on obtaining an MMIS and/or NPI number and the claims submission process
  • The Department will reach out to each of the 19 agencies over the next week

Readiness Payments Information Related to ALL Agencies

  • The Department will notify all agencies when the rate package is approved and processed through a Dear Administrator Letter
  • All allocations must be spent by June 15, 2016
  • All payments will be reconciled to actual care days for all agencies
  • Funding can only be used to support activities directly related to the Medicaid eligible foster care population
  • The Expenditure Budget and Work Plan submitted as part of each agencies' contract will be used to document and support claims for reimbursement of expenses through the per diem
  • Expenses must be in accordance with the items contained in the approved Expenditure Budget and Work Plan
    • Agencies that want to alter their original submission of proposed expenditures must submit a revised Work Plan and Expenditure Budget DIRECTLY to DOH at VFCAManagedCareTrans@health.ny.gov
    • You do not need to revise your contract or submit revised work plans and budgets through the Grants Gateway system

ALL Agencies are Required to Submit a Final Readiness Funds Report by 8/15/16

  • Your final report must include details on how your readiness funds were used to achieve the goals set forth in your work plan
  • The Department will provide agencies a template for the report
  • Reports due on or before 8/15/16
  • Reports submitted to the Department of Health and OCFS at VFCAManagedCareTrans@health.ny.gov

Please direct any questions to VFCAManagedCareTrans@health.ny.gov

This webinar will be posted to the Department of Health website at http://www.health.ny.gov/health_care/medicaid/program/medicaid_health_homes/vfca_mc_readiness_funds.htm