michigan’s waiver · new user security roles ... hho or wsa-hhbh access request form, which is...
TRANSCRIPT
July 2020
Michigan’s Waiver
Support Application
HHO and HHBH
Overview
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What is the Waiver Support Application?
The Waiver Support Application (WSA) is the generic term
we use when talking about the “waivers”
These are the waivers currently housed in WSA: Autism - AUT
Brain Injury Program - BIP
B3W
Children’s Waiver Program – CWP
Habilitation Adult Benefit – HAB
Home Health Behavioral Health – HHBH
Home Health Opioid – HHO
Integrated Care Organizations - ICO
MiCare
Severe Emotional Disturbance - SED
How is WSA Used?
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✓WSA is used for beneficiary enrollment, maintenance, and is the management tool for the waivers.
✓The HHO program treats beneficiaries having claims and/or encounters with a diagnosis of Opioid Use Disorder (OUD) within the past 18 months.
✓The HHBH program treats beneficiaries that have claims and/or encounters with a diagnosis of SMI/SED within the past 18 months.
✓Eligible individuals are automatically identified during nightly batch processing and loaded into the HHO or HHBH application with a potential enrollee status, and then manually enrolled upon engaging with the PIHP.
✓When enrolling an individual the PIHP must attest that the individual meets clinical criteria, obtain the individual’s consent to treatment, and assign the provider. Individuals can be enrolled and disenrolled as often as necessary.
✓There is additional criteria that a beneficiary must meet to be to be picked up for enrollment in the HHO and HHBH programs.
HHBH Diagnosis Codes Currently HHBH is only in NMRE with 95 beneficiaries enrolled.
Medicaid beneficiaries with a specific ICD-10 Code for Serious Mental Illness
or Serious Emotional Disturbance, including the following:
• F41 Other anxiety disorders
• F32 Major depressive disorder, single episode
• F43 Reaction to severe stress, and adjustment disorders
• F33 Major depressive disorder, recurrent
• F31 Bipolar disorder
• F06 Other mental disorders due to known physiological condition
• F25 Schizoaffective disorders
• F90 Attention-deficit hyperactivity disorders
• F20 Schizophrenia
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Nightly Batch Process for HHBH Nightly batch process identifies beneficiaries who qualify for enrollment
This process runs on the Health Services Data Warehouse (HSDW), which
contains several years of Claims, Encounters and Eligibility data
County of residence in one of the counties served by Northern Michigan
Regional Entity, Northcare Network, and Oakland
Currently enrolled in one of the Medicaid full benefit plans (Medicaid,
Healthy Michigan Plan, MiChild)
Has a diagnosis of Serious Mental Illness/Serious Emotional
Disturbances (SMI/SED) in the past 18 months
Not in spenddown
Not deceased
Not in an excluded benefit plan (Opioid Health Home, MiCare, Integrated
Care Organization, Nursing Facility, Hospice)
Beneficiaries who meet this criteria
NMRE – 30,000, Northcare – 15,000, Oakland– 41,000
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Nightly Batch Process for HHO Nightly batch process identifies beneficiaries who qualify for enrollment
This process runs on the Health Services Data Warehouse (HSDW), which
contains several years of Claims, Encounters and Eligibility data
County of residence in one of the counties served by Northern Michigan
Regional Entity, Northcare Network, Macomb County CMH Services,
Southwest MI Behavioral Health (Calhoun and Kalamazoo counties only)
Currently enrolled in one of the Medicaid full benefit plans (Medicaid,
Healthy Michigan Plan, MiChild)
Has a diagnosis of Opioid Use Disorder (F11 ICD-10 diagnosis codes) in
the past 18 months
Not in spenddown
Not deceased
Not in an excluded benefit plan (Health Home Behavioral Health, MiCare,
Integrated Care Organization, Nursing Facility, Hospice)
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HHO Data Beneficiaries who meet this criteria
NMRE – 3,200 (approx. 420 enrolled)
Northcare – 1,600
Macomb – 4,500
Calhoun/Kalamazoo – 1,700
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Medicaid Health Plans
PIHPs and CMHs (Behavioral Health)
ICOs (Integrated Care Organizations)
FQHCs (Federal Qualified Health Centers)
MDHHS
SUD Provider Organizations
WSA – User Organizations
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New User Security roles determine a user’s access level and are dependent
upon whether the user is a Prepaid Inpatient Health Plan (PIHP)
worker or a Michigan Department of Health and Human Services
(MDHHS) worker.
All users request access to HHO or HHBH by completing the WSA-
HHO or WSA-HHBH access request form, which is located in the
Database Security Application (DSA). Both the WSA and the DSA
are accessed through the State of Michigan (SOM) single sign-on
portal, called MILogin.
Users must have a MILogin account before they can complete these
steps.
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HHBH and HHO Lead Entity User Roles Assigned The Lead Entity will be the PIHP for the region.
The role assigned to the PIHP will continue to be the PIHP role.
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HHO and HHBH HHP User Role This role will be added for someone who is directly employed at the
Health Home Partner agency and they must be the lead provider for
the consumer’s care.
The name of the role will be HHOHHPartner or HHBHHHPartner.
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The Multifactor Authentication PageClick Preferred Delivery Method for Code
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WSA Home Page Select HHO or HHBH
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Beneficiary Search Page
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Enroll a Beneficiary
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Disenroll a Beneficiary
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Counts
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HHBH Reports
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HHO Reports
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