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MEDICAID UPDATES

MEDICAID UPDATES. 19th Annual Transportation Disadvantaged Best Practices and Training Workshop  August 2011. Policies and Procedures. Contract requires that STPs shall have written policies and procedures for the provision of Transportation Services, as specified in the Agreement.

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MEDICAID UPDATES

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  1. MEDICAID UPDATES 19th Annual Transportation Disadvantaged Best Practices and Training Workshop  August 2011

  2. Policies and Procedures • Contract requires that STPs shall have written policies and procedures for the provision of Transportation Services, as specified in the Agreement. • Commission Policies and Procedures • Will be monitored during 2011/12 Quality Assurance Reviews

  3. Medicaid Beneficiary Handbook • Provide to Beneficiary within 7 Calendar Days following determination of a eligibility to receive Transportation Services • Template will be available on CTD Website • Variation must be approved by CTD

  4. Encounter Data • Encounter data must be submitted for ALL trips provided • Include trips reported on Trip Travel Expense Report • Must be submitted to support Invoice • Continue to work with Software Vendors • Data is being reviewed for accuracy and completeness • System validations

  5. Encounter Data • Issues • Beneficiary Eligibility • Social Security Numbers • Actual Pickup and Actual Drop Off Times • Trip Distance • Trip Cost • Trip Indicator • Trip Mode

  6. Encounter Data Beneficiary Eligibility • Use CTDFL • CTDFL data is supplied directly from AHCA • Data may be rejected when submitted to AHCA • Advise CTD of discrepancies with eligibility Social Security Numbers • Must be accurate • Data will be rejected when submitted to AHCA for validation

  7. Encounter Data Actual Pickup and Actual Drop Off Times • Times must be reported accurately • Used for on-time performance measures • Use HHMM – 24 hours • Only use “0” for No-Shows Trip Distance • Mileage must be reported accurately • Report “1” mile for Bus Passes

  8. Encounter Data Trip Cost • Use Unsubsidized Fully Allocated Cost from Rate Model Worksheets • Include all travel related expenses that are reported on the Trip Travel Expense Report Trip Indicator • Initial, Transfer, Return • Report correctly, all trips can not be initial or return

  9. Encounter Data • Trip Mode • Can be confusing because it mixes terminology that overlaps Beneficiary need vs. vehicle type • The best way to explain which TYPE is appropriate is to select the BEST answer (type)

  10. Encounter Data • MV -should only be used to reflect trips that are not otherwise included in a more specific category. • PT - door to door paratransit services that are provided by a publicly owned transit system. Examples include 5307 or 5311 subsidized systems that invoice on a per trip or mile basis. You must be able to report passenger miles associated with each trip. • VT - Private Volunteer Transport. • WC - trips where the Beneficiary is in a wheelchair or scooter and cannot transfer themselves from their wheelchair, thereby needing a vehicle that can accommodate a wheelchair/scooter. • ST - trips where the Beneficiary is transported on a stretcher by a specialized stretcher vehicle

  11. Encounter Data • OB - Over the road bus (typically thought of as Greyhound) • CA - Commercial Air • BP - single day, multiple days, and monthly passes on a FIXED ROUTE public bus system. Passenger miles for any BP trip must be reported as 1.0 mile. Only report the number of “one-way” Medicaid related passenger trips for which the BP is being used to satisfy. • TX - Any service in a Taxi excluding wheelchair taxis. A Beneficiary in a manual wheelchair who can transfer themselves and their manual fold up chair should be categorized as TX.

  12. Best Practices • Utilization of Volunteers • Gatekeeping Strategies • Fixed Route • Customer Service • Reporting • Partnerships

  13. Updates • Funding Allocations are being reviewed by the Commission • STP Contracts will be amended shortly to incorporate changes made in Commission’s contract with AHCA • Questions???? Thank you

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