1 / 10

Alaska EI/ILP & Medicaid Targeted Case Management

Alaska EI/ILP & Medicaid Targeted Case Management. What it is Why we did it How it is working December 5, 2006. EI/ILP (Alaska’s Part C Program). Lead Agency is Department of Health and Social Services Provider agencies are grantees of DHSS, compliance assured through grant agreements

trilby
Download Presentation

Alaska EI/ILP & Medicaid Targeted Case Management

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Alaska EI/ILP & Medicaid Targeted Case Management What it is Why we did it How it is working December 5, 2006

  2. EI/ILP (Alaska’s Part C Program) • Lead Agency is Department of Health and Social Services • Provider agencies are grantees of DHSS, compliance assured through grant agreements • Family service coordination (FSC) by direct service providers, usually employees of grantee agencies

  3. Medicaid Targeted Case Management • Service category available for Medicaid recipients • “Targeted” means case management for a specific population • “Case Management“ services assist eligibles to gain access to needed medical, social, education, and other services

  4. Medicaid Targeted Case Management • Medicaid State Plan Amendment approval • Describes target population • Outlines billable activity descriptions • Defines provider qualifications • Provides assurances to CMS • Outlines Payment Methodology

  5. Medicaid Targeted Case Management • Payment Methodology • Rate Based on Real Costs • Monthly Encounter Rate • Adjusted annually for inflation • Approximately $245/month/child

  6. Targeted Case ManagementGeneral Policy Description • Follows all applicable state, federal laws and regulations • Designed to align with current EI/ILP practices (TCM = FSC) • Administrative simplicity • Intra-departmental communication

  7. Targeted Case ManagementGeneral Policy Description • Grantees are qualified providers • Billing receipts = grant income; must be used to further grant objectives • Qualified providers must enroll with Medicaid • Unique Provider ID needed to bill for TCM

  8. Targeted Case ManagementGeneral Policy Description • Children must be Medicaid eligible to bill for TCM • Title XIX or Title XXI (Denali KidCare) • Statewide eligibility rate is 30-35% • EI/ILP Medicaid eligibility rate is 55-60%

  9. Targeted Case ManagementGeneral Policy Description May bill the monthly rate after minimum of one documented qualifying case management contact in a month Onecharge per month per child = 12 monthly charges / child/ 12-month period maximum

  10. TCM Pilot Project – Phase I • Enrollment Process • Outreach Connections/Activities • Successfully Identify Qualifying Activities • Documentation Standards and Methods • Recordkeeping / Billing Mechanisms in place

More Related