Schools and Medicaid Quarterly Call Highlights

Schools and Medicaid Quarterly Call December 5, 2017 1

Call Reminders Put your name and district or company represented in chat box Phone lines will be muted during most of call, so enter questions in chat box Phone lines will be unmuted during open forum at end of call. Please mute your line at this time and do not put on hold (as some districts have music or announcements that play while on hold) 2

Agenda Introductions - AHCA and FDOE/SSS staff FFS - Luc - Revisions/SPA status - (FFS, charter/private schools/free care guidance) - NCCI changes and denials and dates of changes - Fee schedule dated 1/1/17 revisions - Florida Administrative Rule 59G-1.054 AHCA Monitoring: Refresher on transportation monitoring - Jeffrey SDAC - Ami - Requesting payroll - Prorating salaries - Cost pool FDOE/SSS - Anne - Parental consent and notification - Documenting Transportation on the IEP Report from NAME conference Broward County School District Open Forum-Call attendees enter questions in chat box 3

Fee for Service: Rule Revisions/SPAs Status/Updates Medicaid Certified School Match Handbook (2005) Private/Charter Schools Rules related to CMS Free Care guidance 4

Medicaid Fee Schedules Effective 1/1/17 Medicaid Health Care Alert 2/7/17-Fee Schedules http://ahca.myflorida.com/medicaid/review/fee_sc hedules.shtml Sign up for Medicaid Health Care Alerts http://ahca.myflorida.com/Medicaid/alerts/alerts.s html Fee schedule in process of review and correction 5

FAC 59G-1.054: Recordkeeping and Documentation Requirements Rule effective effective 5/8/17 (2) Documentation Requirements. (a) All Florida Medicaid providers must: 1. Ensure medical records establish the medical necessity for and the extent of services provided. 2. Sign and date each medical record within two business days from the date and time of service, or otherwise authenticate the record by signature, written initials, or computer entry. Electronic signatures are permissible as defined in Chapter 668, Part I, F.S. 6

Monitoring: Transportation Documentation: Reference for the Specialized Transportation Policy: MCSM handbook, page 5-3 1. Does the IEP or IFSP reference specialized transportation services meeting one of the following three criteria for specialized transportation; medical or vehicle adaptive equipment required; medical condition that requires a special transportation environment; or attendant required due to disability and specific needs of student? 7

Monitoring: Transportation Reimbursement: Medicaid Reimbursable Service on the Same Day Policy: MCSM handbook, page 5-4 2. Was a Medicaid-reimbursable service (other than specialized transportation service) provided on the date of service specialized transportation was billed (either at school, off school campus, or both)? 3. Was the Medicaid reimbursable service (other than specialized transportation) referenced in the IEP or IFSP? 8

Monitoring: Transportation Documentation: Trip Logs Policy: MCSM handbook, page 5-5 4. Does the trip log contain the student's name? 5. Does the trip log contain the date of service of transportation? 6. Does the trip log contain the bus driver's or attendant's initials verifying the student was transported? 7. If an alternate method of documentation was used instead of a trip log, was the method used in lieu of a trip log approved by the proper officials? 9

Monitoring: Transportation Reimbursement: Trip Logs Policy: MCSM handbook, pages 5-4 8. Were no more than 2 one-way trips (to school from home, to home from school, to off-campus from school, or to school from off- campus) billed on this day? 9. Are documented units of service for the date of service in agreement with the paid claim? 10

Documenting Transportation on IEP Transportation is a related service under IDEA Must be documented in the IEP No specific section requirement 11

SDAC Claiming salaries and benefits - Payroll documentation -Requesting Payroll - Prorating Staff included in sample - Non-federally funded salaries and benefits only 12

Parental Consent/Notification Reminder Parental consent one time Notification annually Addressed in Florida Administrative Code 6A- 6.03028(3)(q) Procedures for students with disabilities who are covered by public benefits or insurance Parental consent form (sample) in English, Creole, Spanish at http://sss.usf.edu/resources/topic/medicaid/inde x.html 13

Parental Consent d. Prior to accessing the student s or parent s public benefits or insurance for the first time, and after providing notification to the student s parent as described in sub-subparagraph e. of paragraph (3)(q), the school district must obtain written, parental consent that specifies: (I) The personally identifiable information that may be disclosed such as records or information about the services that may be provided to the student; (II) The purpose of disclosure, such as for purpose of billing for services; (III) The agency to which the disclosure may be made; and, (IV) That the parent understands and agrees that the school district may access the parent s or student s public benefits or insurance to pay for services required under Rules 6A-6.03011- .0361, F.A.C. e. Prior to accessing a student s or parent s public benefits or insurance for the first time, and annually thereafter, the school district must provide written notification consistent with the requirements found in paragraphs 6A-6.03311(1)(a) and (b), F.A.C., to the student s parents that includes: (I) A statement of the parental consent provision in sub-subparagraph d. of this paragraph; (II) A statement of the no cost provisions of subparagraph (3)(q)1.; (III) A statement that the parents have the right to withdraw their consent to disclose their child s personally identifiable information to the agency responsible for the administration of the State s public benefits or insurance at any time; and, (IV) A statement that the withdrawal of consent or refusal to provide consent to disclose personally identifiable information to the agency responsible for the administration of the State s public benefits or insurance program does not relieve the school district of its responsibility to ensure that all required services are provided at no cost to the parents. 14

Annual Notification e. Prior to accessing a student s or parent s public benefits or insurance for the first time, and annually thereafter, the school district must provide written notification consistent with the requirements found in paragraphs 6A- 6.03311(1)(a) and (b), F.A.C., to the student s parents that includes: (I) A statement of the parental consent provision in sub-subparagraph d. of this paragraph; (II) A statement of the no cost provisions of subparagraph (3)(q)1.; (III) A statement that the parents have the right to withdraw their consent to disclose their child s personally identifiable information to the agency responsible for the administration of the State s public benefits or insurance at any time; and, (IV) A statement that the withdrawal of consent or refusal to provide consent to disclose personally identifiable information to the agency responsible for the administration of the State s public benefits or insurance program does not relieve the school district of its responsibility to ensure that all required services are provided at no cost to the parents. 15

NAME Conference 300+ attendees Florida school districts represented: Broward, Leon, Volusia, Seminole, Polk, Levy, Palm Beach, Santa Rosa, Bay, Collier, Orange, Brevard Presentations that included Florida district and FDOE staff included sessions related to transportation reimbursement, trauma and mindfulness, Florida s Medicaid in schools program, therapy services, specialized transportation, and overcoming challenges with the Child Find program Feedback from school district attendee 16

NAME Conference Presentation Information Over the next 6 months will have calls for districts to share information from their presentations at NAME conference First call January 23: Julie Accorsini, Medicaid Manager, Collier County School District: Four Powerful Strategies to Uncover the Full Potential in Your District s Reimbursement 17

SSS Website-Medicaid pages SSS Website http://sss.usf.edu/resources/topic/medicaid/i ndex.html Posted FAC (rule) on parental consent Notes from prior Medicaid and schools calls Reminder: Send information for sharing with other districts 18

Open Forum Phone will be taken off of presentation mode- please mute your phone line if you are not speaking. If you have comments or questions, please identify yourself and your district. 19