Florida Medicaid UpdateMay 2015

Evelyn Leadbetter,Network Services

MAY AHCA UPDATES

The Agency for Health Care Administration has scheduled a public hearing for the repeal of Rule 59G-8.100, Medicaid Contracts for Prepaid Health Plans. The public hearing is scheduled for May 28, 2015 from 10:00 a.m. to 11:00 a.m. ET at the: Agency for Health Care Administration, Tallahassee, FloridaThere will not be a phone call-in number available.

AHCA Health IT Symposium, Going Digital: Helping Florida Get Connected: June 26, 2015 7:30 a.m. – 12:15 p.m. in Tallahassee, Florida Engage with industry leaders, subject matter experts, and Agency for Health Care Administration

representatives through panel discussions. This event will unite stakeholders in the exploration of health information technology (Health IT), interoperability of electronic health records, security and privacy considerations, and practical applications of Health IT services. Register Here!

Prepare for ICD-10: MLN Connects Videos and June 18 CallNew Videos: Impact on Inpatient Hospital Payment and Medicare Testing PlansEstimating the Impact of the Transition to ICD-10 on Medicare Inpatient Hospital Payments: Run time: 29 minutesMedicare’s Testing Plan for ICD-10 Success: Run time: 7 minutes

June 18 Call: Preparing for Implementation and New ICD-10-PCS Section XIt’s not too late to get ready for ICD-10 implementation on October 1, 2015. During this MLN Connects National Provider Call, CMS subject matter experts will present strategies and resources to help you prepare. Also, learn about ICD-10-PCS Section X for new technologies, which will be used by hospitals. Registration is open

Florida Medicaid State Plan Amendments

May 2015 Approvals:

http://www.medicaid.gov/State-Resource-Center/Medicaid-State-Plan-Amendments/Medicaid-State-Plan-Amendments.html?filterBy=Florida

• FL-14-015: The amendment proposes to: increase the diagnosis related grouping for rural hospitals; establish a global fee for bone marrow transplants; clarify the rate setting methodology for the state-owned psychiatric hospitals reimbursed under a per diem methodology; revise the acceptance policy for amended cost reports; and deletes obsolete language

May 2015 Updates

Florida Medicaid is implementing the X12 999 response acknowledgement file.  The 999 reports the acceptance status of an inbound file and shows whether the inbound file is accepted, partially accepted, or rejected.

The 997 response acknowledgement file that is currently received by providers and Managed Care Organizations (Plans) when an inbound X12 transaction is transmitted will be replaced with the new 999 response acknowledgement file transactions effective June 19, 2015.  This change only affects HIPAA Transactions: 270/271 and 276/277.

The 999 file can be downloaded from the Plan’s secure Web Portal account by selecting the 999 document type from the Trade Files menu.  For Plans utilizing SFTP connection, these files will show in the inbound folder. 

Sample 999 files can be found on the Submission Information page on Florida Medicaid’s Public Web Portal.

Florida Medicaid Readiness and Training

• AHCA Florida Medicaid ICD-10 WebinarRegister for the next webinar that will be held on Thursday, June 18, 2015 at 10:30AM – 11:30AM EST

• ICD-10 Managed Care TestingICD-10 Testing for all Managed Care Plans will be mandatory and will occur in July 2015.AHCA, along with its fiscal agent, HP Enterprise Services, will soon be coordinating the ICD-10 testing for the Managed Care Plans.For more information regarding ICD-10 testing and registrationICD-10 Provider Testing Registration Site

• Florida Medicaid’s May ICD-10 Newsletter

• AHCA Registration for Area-Specific ICD-10 Training

• Medicaid.gov ICD-10 Changes from ICD-9

• Staywell/Wellcare of Florida ICD-10 Compliance

• Sunshine Health ICD-10 Overview

• Prestige June Provider Training:

• Access CMS Open Door Forum Information and sign up for July ODFs here.

May Deadline for NPRM Public Comments

The public can submit comments in several ways, including via electronic submission or mail:•Electronically: You may submit electronic comments to http://www.regulations.gov. Follow the "Submit a comment" instructions.•By regular mail•By express or overnight mail•By hand or courier

For More InformationFor more information on the Stage 3 and 2015 Edition certification criteria proposed rules, review the press release and fact sheet.

Stage 3 of Meaningful Use NPRM•Specifies the Stage 3 requirements for eligible professionals, eligible hospitals, and critical access hospitals in the HER Incentive Programs

EHR Technology Certified to the 2015 Edition NPRM•Outlines the certification and standards to help providers meet the proposed Stage 3 requirements with HER technology certified to the 2015 Edition

Legislative Updates 2015

Study of Hospital Funding and Payment Methodologies for Florida Medicaid

Prepared for: Florida Agency for Health Care Administration

Statement from House Speaker – May 22, 2015

THANK YOU!