Friday’s with the ADADQ and A

May 21, 2010

CPA forms are available where?

In order to reduce costs, DHS no longer supplies pre-preprinted copies of the CPA.

DHS-2780 can be found on E-docs Print the form two sided (to include client data

privacy and discrimination appeal) Print as many copies as needed Placing Authority must retain a copy with

original signatures

TEFRA Edit Added to SA

This line item edit applies ONLY to TEFRA enrollees.

County should end TEFRA eligibility before authorizing inpatient services and redetermine client eligibility for MA. If the client is determined eligible for MA & inpatient service is in an IMD (which is not a psych hospital), major program should be IM for the IMD stay.

DAANES Submission and Re-billing of Denied Claims If a provider receives a claim denial because

the claim was submitted prior to the DAANES submission, the provider must re-bill the claim. (MMIS will not automatically re-process the denied claim when DAANES is received.)

Change in Allocations and County MOE as of 7/1/10

SFY 2010 Allocation Bulletin will have new format Allocation language removed from 254B Maintenance of Effort language is also removed Counties pay a 16.14% share of each claim Counties will continue to pay 30% of the non-federal

share for MA clients. (Federal Stimulus Act) Tribes continue to pay no share Admin allowance is now limited to lesser of:

current percentage determination (5,4,3%) or SFY 2009 admin adjusted by percentage change in

current appropriation

Tribal 638/ no county share

Tribal 638 programs receive a daily federal encounter rate ($268) for treatment services for American Indians on MA. (CCDTF rate for R&B)

3 county located programs are now, or are in the process of receiving the 638 identification

Counties will pay no county share for treatment costs for American Indian persons on MA at Tribal 638 programs. (MMIS is being programmed currently. County share charged in SFY 2010 will be identified and credited)

ADAD will issue a bulletin in the near future

GAMC Update Enacted legislation calls for new hospital-based Coordinated Care

Delivery Systems (CCDSs) to provide services to General Assistance Medical Care (GAMC) enrollees as of June 1, 2010

DHS mailed notices May 17 to all current GAMC enrollees.

DHS issued a bulletin May 18 to county and tribal agencies and other partners.

Frequently Asked Questions (FAQs) and links to the enrollee notice and bulletin are posted on the DHS website at www.dhs.state.mn.us/gamc

DHS will continue to post updates on the website as they become available.

GAMC recipients are eligible to receive CD services through the CCDTF..

Rule 25 Assessment

Regardless of all rumor, and rural and urban myth:

Rule 25 assessment is required for all fee for service (CCDTF) and state contracted managed health care clients.