2/17/15

CCPAC Meeting

Department on Aging Update

  • Staffing changes – Jennifer Reif spoke on this topic.
  • No new staffing changes announcements and there is not a designated time frame when they will be announced.
  • Jon Holton is now referred to as the Acting Director of the Department on Aging.
  • Jennifer Reif will be overseeing SHIP, CCP, Senior Health Life, Training and BEAM.
  • Dennis Miner and Scott Norton are also actively involved. Dennis said Jennifer Vaughan is the current Internal Auditor. Alexander Burge is the Legislation Director; Sonia Bhabwacker is still General Counsel.
  • Budget – Dennis Miner spoke on this topic.
  • Fiscal Year 2015 has sufficient funds to complete the year.
  • He will not speak on Fiscal Year 2016; we will have to wait until the Budget Address on 2/18/15.
  • There will also be a briefing after the Budget Address.
  • The IDOA Comptroller is currently processing November 2014 payments. If a provider has a payment over 90 days, then they are eligible to request an expedited payment. Please make sure when billing is submitted that all the information is correct. Social security numbers, among other things, are sometimes omitted which makes the payment process longer.
  • IDOA has a handle on the fraud situation with the review and monitoring policy that they have put into place. Data goals are being discussed. IDOA is speaking with other departments regarding the importance on transparency across the board.
  • IDOA is open to suggestions that will assist the program.
  • Data quality is critical – currently working with IT to make everything is correctly in place.
  • Quality & Program Issues – Mary Gilman spoke on this topic.
  • An email was sent to CCU’s and Providers last Friday regarding discrepancies. If you did not receive one, then you don’t need to worry about this email.
  • Regarding the issue discovered November 2014; they are now looking at the CCP participants and cross checking the death date with IDPH records. IDOA just got access to the death date information a year earlier. IDOA stopped payment on 1000 participants until this matter is cleared up. This number will go down after providers let the IDOA know if the person is living or deceased. If living, they will restart the program.
  • Discussed “How to prove someone is alive” – need to know how Public Health use this information and then create a program that will cross reference the Public Health information with the information the provider provided. Some providers have actually taken pictures of clients with their SS cards.
  • Discussing: CCU’s the date must match the Public Health death date.
  • Discussing: EDD should be day after death and not two weeks
  • These policies are still in review
  • Questions were raised about no shows for services when family fails to notify provider of death. HCW or ADS may go to home so could bill a no show fee.
  • For actual fraud cases, IDOA will send HFS to investigate through OIG office.
  • Ship Grant
  • Due tomorrow for the amount of $1.4 million. Anticipate that it will be paid. The turnaround is 30-40 days.
  • Train the training will be in the St. Louis area this July. Department will do the training.
  • Department will do a better job on documenting the training and attendance. At this time, Illinois is not ranked very high
  • Ship services.
  • Managed Care
  • Training is a large focus for Managed Care
  • The eCCPIS is going to offer extensive training on their website
  • For Providers – information about Managed Care Organizations
  • Presentations from the 2014 Governor’s Conference
  • Billing webinar
  • For those using CMIS – there will be a data entry class
  • There will be a CCP101- How to be a Good Case Manager for Managed Care Case Workers; HFS will make this mandatory for all case managers.
  • Revisions regarding switching from CCP to MCO & MCO to CCP. Policy changes only for CCP Also, CCP’s need to put DON scores on the Pre-screening because HFS/CMS is questioning assessments because they do not have enough information.
  • Problems with billing for ADS as MCOs do not bill with same numbers CCP does (ID# and SS) but use WREN#. Providers need to bill with only that number.
  • MCOs have been paying providers a % of their bill based on the way they normally pay. This is found with providers Molina, Meridian, and Humana. IDOA is aware of this problem. Any provider experiencing this with their payments should send all information to BEAM @ . Robin Morgan needs to keep track of all of these issues and track resolutions as well. The more data they gather to support MCO’s concerns, the more strength it gives to timely requests for resolutions.
  • Policy Updates
  • New Procurement cycle is ready to start after 6 year cycle. Providers will need to do new applications for legal entity and a service contracts. Providers should be watching for the emails regarding this important information.
  • MLTSS ( Mandatory Long Term Support Services) is turning MMAI, choice for clients to opt out of MCOs services into a mandatory all MCOs program.

No longer will those who originally opted out and stayed with Medicaid be allowed to remain there. They will soon have to choose a MCO or it will be chosen for them. It is now going to become a mandatory participation program. May 1st is as soon as they will come onto MCOs. This is a HFS decision.