CMS HCBS Rate Setting, Fiscal Integrity, and EVV Technical Assistance Available through Medicaid.gov Website
The Centers for Medicare and Medicaid Services (CMS) has contracted with Lewis and Ellis and Korn Ferry to offer free direct technical assistance (TA) to state Medicaid agencies to assist with program and regulatory compliance for home and community-based services (HCBS) rate development and electronic visit verification (EVV).
States are now eligible to receive TA for the following services:
- For HCBS Rates and Fiscal Integrity Technical Assistance, TA services are available to:
- Give feedback on HCBS rate methodologies and/or waiver service rate models
- Assist with cost estimates in Appendix J
- Provide guidance regarding rate review, rate sufficiency, and financial accountability strategies
- Provide guidance on 1915(c) quality improvement system (QIS) performance measures
- For EVV Systems, TA services are available to:
- Assist with determining the most appropriate EVV Model for the State
- Provide guidance regarding 21st Century CURES Act Sec. 12006
- Supply promising practice examples of EVV Systems
- Review and provide opinions regarding policy documents related explicitly to EVV implementation
- Review proposed 1915(c) Waiver language
To see more information and make a request please visit: HCBS Technical Assistance Request.Please note that TA requests must have the approval of the state’s State Medicaid Director in order to be considered.
Preventing Unallowable Costs in HCBS Payment Rates:
June 13, 2018: 1:30pm – 3pm EST
The objective of this training is to build on previous training on financial accountability and data validation, provide overview of unallowable costs and methods to prevent including unallowable costs into rates and payments. CMS will provide Medicaid HCBS guidance regarding unallowable costs. Lewis & Ellis with assistance from Navigant Consulting is currently the training lead through the Rate Review Multi-Award Contract overseen by the Division of Long Term Services & Supports (DLTSS). Lewis & Ellis and Navigant Consulting will present the training and Ralph Lollar, DLTSS Division Director, and the DLTSS Team will support the training and lead the Q&A Session.
To register for the webinar, click on this link: https://insidenci.webex.com/
Medicaid Innovation Accelerator Program (IAP)
Medicaid IAP Data Analytics Webinar for States (June 7, 2018)
Introduction to Missing Data
On Thursday, June 7th, 2018 from 3:00 – 4:00 PM ET, CMS’s Medicaid Innovation Accelerator Program (IAP) will host a national webinar for state Medicaid agencies interested in learning about analytic strategies that can be used to address missing data. In this interactive webinar, states will learn about the different types of missing data and the analytic ramifications of each type.
Presenters will share different perspectives on addressing issues associated with missing data. For example, participants will learn about univariate versus multivariate missing data along with basic strategies to address these challenges. In addition, a presenter from Alabama Medicaid will also share their experience addressing missing data across claims, vital statistics, and medical chart review in their analyses of maternity care delivery.
To register for the webinar, click on this link: https://cc.readytalk.com/r/
Medicaid IAP National Learning Webinar (June 14, 2018)
Using Quality Improvement to Determine Whether Your Medicaid Delivery System Reform is Effective
The Medicaid Innovation Accelerator Program is hosting a national webinar on Thursday, June 14th from 3:00 – 4:00 PM ET about how quality improvement tools and techniques can be embedded into Medicaid delivery system reforms (DSRs) to assist state Medicaid officials in determining whether their reform activities are having the desired effect. The webinar will provide states with the opportunity to learn about quality improvement tools and techniques, and how they can applied to their own Medicaid agencies’ reform work. Quality improvement tools and techniques can create efficiencies by helping state Medicaid agencies identify DSR goals upfront, determine whether changes are improvements, and continue to make progress toward their goals.
During this webinar, you will hear an example from your colleagues in Ohio Medicaid about how they are using these tools and techniques to drive their maternal and infant health DSR goals. We hope you join us for this engaging, interview-style webinar which will also review key concepts and highlight potential results!
To register for the webinar, click on this link: https://engage.vevent.com/rt/
Recent Announcements
To ensure states are aware of changes to the Medicare DME benefit that may be of interest, we are highlighting CMS’ recent announcement in the Federal Register the selection of 31 additional items of durable medical equipment to be subject to Medicare-required prior authorization beginning on September 1, 2018. We remind State Medicaid Agencies that when a supplier requests Medicare prior authorization, a non-affirmed prior authorization decision is sufficient for meeting states’ obligation to pursue other coverage before considering Medicaid coverage (please see the January 13, 2017 Informational Bulletin, found here).
The HCPCS codes being added to Medicare’s Required Prior Authorization List are all part of the Prior Authorization of Power Mobility Devices (PMDs) Demonstration that has been operating in 19 states. Beginning September 1, 2018, prior authorization will be required for these codes as a condition of Medicare payment in all U.S. states and territories. Additional information is available on the DMEPOS Prior Authorization webpage (the complete list of codes and descriptions can be found in the Downloads section) here.
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