Policies Proposed to Modernize Medicaid Continuum of Care
Posted on September 15, 2017
The Medical Services Administration (MSA) recently released several proposed policies related to the Medicaid Modernizing Continuum of Care (MCC) project. One proposed policy would eliminate the paper version of the admission notice used when a beneficiary is admitted to a long-term-care facility. If the proposal is finalized, the Michigan Department of Health and Human Services (MDHHS) would stop accepting the Facility Admission Notice form (MSA-2565-C) for facility admissions, effective Dec. 15. Hospitals could continue to submit a modified MSA-2565-C to establish Medicaid eligibility for newborns when a hospital is unable to submit notice of the birth through the state’s Electronic Birth Certificate system. MDHHS case workers would no longer enter admissions into the Bridges system for admissions received on paper MSA-2565-C forms after Dec. 29. Comments on this policy are due to Bridget Heffron at the MSA by Oct. 17.
Another proposed policy would require that providers enter admissions/enrollments to their facility/program directly into the Community Health Automated Processing System (CHAMPS). The proposal includes hospital, nursing facility, hospice, MI Choice Waiver and Program of All-inclusive Care for the Elderly (PACE) providers and would take effect Jan. 2, 2018. This should streamline the process of entering Medicaid coverage into the Bridges system and CHAMPS when an application or beneficiary is admitted to a long-term-care-facility, minimizing the delay caused by the current paper process. Comments on the policy are due to L. Alisyn Daniel, Esq., at the MSA by Oct. 17.
The MSA also released a proposed policy regarding changes related to the implementation of the CHAMPS MCC project. This proposal outlines changes related to the eligibility inquiry/response transaction and the unique health plan identification number (ID). Under the policy, which would take effect Jan. 2, 2018, managed care entities would move from multiple CHAMPS provider IDs to a single provider ID per contract. In addition, level of care (LOC) codes would be replaced with program enrollment type (PET) codes that identify a beneficiary’s type of admission or managed care enrollment and their living arrangement. If the policy is finalized, patient pay amounts would be provided separately in a new “Patient Pay” section at the bottom of the eligibility response page. The LOC segment will be removed from the eligibility response page. Comments on this proposal are due to Jessica Combs at the MSA by Oct. 17.
Members who have concerns on any of these policies may ask the MHA to include their issues in the association’s comments to the MSA by contacting Jason Jorkasky at the MHA no later than Oct. 10.
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