Financial Management Services Agency Quarterly Technical Assistance Webinar

Consumer Directed Services Medicaid/CHIP Division May 2017

Agenda

• Introduction and Welcome • Texas Medicaid Healthcare Partnership Enrollment • Update from Texas Council on Consumer Direction Chair • Navigating the Consumer Directed Services Website • Discussion: Budget Workbooks • Processing Transfers • Financial Management Services Agency (FMSA) Contract

Compliance and Performance Management • Consumer Directed Services staff reminders • FMSA Q & A

Texas Council on Consumer Direction Nancy Crowther, Council Chair

Texas Medicaid Healthcare Partnership (TMHP) Enrollment Lisa Cruz Hidrogo, Special Projects Manager

Provider Enrollment • Health and Human Services Commission is using a

manual enrollment process for providers that currently have APIs assigned until an automated process is available at TMHP for MCO LTSS providers.

• Providers assigned an Atypical Provider Identifier (API)must complete managed care organization (MCO) long-term services and supports (LTSS) provider enrollment process no later than January 1, 2018.

Provider Enrollment (page 2) • Providers not enrolled by the deadline may be

unenrolled from the MCO LTSS program • FMSAs can enroll through TMHP and must do so

before January 1, 2018 • Additional information will be provided regarding

the transition from manual to automated process

Provider Enrollment (page 3) • Request enrollment, get application status, submit

questions or concerns to MCO_LTSS_Provider_Re-enrollment@hhsc.state.tx.us • Request by include:

• Providers business name, • Tax identification number • National provider identifier

• Question and answer document is being prepared for distribution which provides additional information regarding the process

MCO_LTSS_Provider_Re-enrollment@hhsc.state.tx.us

Navigating the Provider CDS Website https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/consumer-directed-services-cds

Navigating the Provider CDS Website

Navigating the Provider CDS Website

• CDS Option Webinars • FMSA Quarterly Technical Assistance Webinars

• Forms and Handbooks • Consumer Directed Services Option Handbook • Budget Workbooks • Sample forms for employers

• Training Opportunities • CDS Support Advisor Certification Computer-based

Training (CBT) • Training Presentations

• Internal Revenue Service (IRS) sample forms • CARE billing

Navigating the CDS website https://hhs.texas.gov/services/disability/consumer-directed-services

Navigating the CDS website

Navigating the CDS website (page 2) • Service Delivery Option

• Agency Option • Employer Option (CDS) • Service Responsibility Option

• Employer Resources • Consumer Directed Services Option Employer

Manual • PDF Document of Roles and Responsibilities

• Using an Unlicensed Employee to Perform Nursing Tasks

Processing Transfers

Texas Administrative Code (TAC) §41.403

• An individual's FMSA must process a request by the individual or legally authorized representative (LAR) to transfer from one FMSA to another FMSA in accordance with transfer procedures and requirements of the individual's program.

Processing Transfers

Transferring FMSA Responsibility

Transferring FMSA is responsible for: • Accounting for funds allocated in service plan and budgets

• Bill for funds in the budget that the FMSA must pay • Make payments within required time frames • Submit billing adjustments for prior claims and payments

• Notifying the employer and case manager/service coordinator (CM/SC) of the number of units and amount of funds remaining in budget after scheduled transfer

• Transferring all employer-related and employer-agent related information and reports to receiving FMSA at transfer

Transferring FMSA Responsibility (page 2) Transferring FMSA is responsible for:

• Distributing a final FMSA report to employer, Designated Representative (DR), CM/SC, and receiving FMSA within 5 working days after the transfer

• Submit a satisfaction survey to employer or DR

Processing Transfers

CM/SC responsibilities • Within 5 working days of the receipt of a request to

transfer, the CM/SC must: • Process the individual’s request to transfer according to

program rules • Calculate the number of units or amount of funds needed to

complete the service plan period • Revise the service plan to indicate number of units or

amounts of funds • Approve the units and funds calculated to complete the service

period • Provide copy of transferring service plan to receiving FMSA and

employer • Provide copy of the individual’s revised service plan to

transferring FMSA, receiving FMSA and employer or DR

Processing Transfers

Receiving FMSA Responsibilities

Receiving FMSA is responsible for: • Enrolling the individual and employer with FMSA

including registering the FMSA as the employer-agent • Initiating FMS and employer-agent responsibilities

including • Conducting an initial orientation • Entering in the required service agreement with

employer • Obtain required service agreements with each of

the employer’s service providers

Processing Transfers

Employer/DR responsibilities

Employer/DR must: • provide documentation to receiving FMSA

within five working days, • maintain eligibility of each current

employee; and • provide other documentation requested by

receiving FMSA

Contract Compliance and Performance Management

Patricia Herrin, CDS Contract Specialist

• List of Excluded Individuals/Entities (LEIE) policies and procedures to include missing elements

• Documentation for quarterly reports sent to employer and CM/SC

• Written approval of budget prior to initiation of services and budget revisions

• Completing Forms

Contract Compliance and Performance Management Craig Williamson, Financial Analyst

• Obtaining Employer Identification Number (EIN) & Taxpayer Identification Number (TIN) before accepting transfers

• Completing Forms 1730 or Form W-4 when changes occur

• Using the effective Texas Workforce Commission (TWC) tax rate for the budget year

CDS Staff Reminders • Budget Issues:

• Bonuses must be reflected in the appropriate section of the budget

• The CDS budget is based on the authorized service plan. The hours (or units) entered MUST match the units allowed for that particular service in the service plan.

• Form Updates • Technical Assistance Webinars are mandatory, sign in

with contracted entity name • Send training requests to CDS inbox at

CDS@dads.state.tx.us • Make sure your agency is signed up for GovDelivery at;

https://service.govdelivery.com/accounts/TXHHSC/subscriber/new?topic_id=TXHHSC_65

Questions and Answers CDS@dads.state.tx.us