Florida Medicaid UpdateOctober 2015

Evelyn Leadbetter, MPAHTH Network Services Manager

October AHCA Updates

Florida Medicaid October ICD-10 Newsletter Now Available

In this issue: ICD-10 is now live! Email Support Questions? Find Answers Here ICD-10 Clinical Concepts Series

CMS ICD-10 FAQ: https://www.cms.gov/Medicare/Coding/ICD10/Frequently-Asked-Questions.html

CMS: October ICD-10 FAQ

Coding: From the Centers for Disease Control and Prevention: Interpretation of Excludes1 no

tes in ICD-10-CM when the conditions are unrelated to one another. (Posted October 16, 2015)

CMS: October ICD-10 FAQ

Coding: What qualifier do I use for ICD-10 diagnosis codes on electronic claims?

(Posted October 16, 2015)

https://www.cms.gov/Medicare/Coding/ICD10/ICD-10-Provider-Contact-Table.pdf

Transition of Integral Quality Care Members to Molina Healthcare of Florida, Inc.

Molina Healthcare of Florida, Inc. (Molina) purchased Integral Quality Care’s (Integral) Medicaid line of business.  The Agency for Health Care Administration will transition Integral’s Medicaid membership to Molina effective November 1, 2015.Molina will be issuing new Member ID cards.  All billing and claims reimbursement will be provided by Molina for dates of service beginning November 1, 2015.  All claims for service dates prior to November 1, 2015, must continue to be submitted through Integral and related questions may be directed to Integral’s provider services number at 1-866-258-4326. 

Questions related to this transition may be directed as follows: 

Molina Member Services: 866-472-4585 Molina Provider Services: 855-322-4076

Website: www.molinahealthcare.com

Upcoming MPI Field Initiatives

During the remainder of FY 2015-16, MPI intends to conduct site visits to providers of different specialties throughout the state of Florida.  The focus of MPI’s on-site provider reviews will include, but is not limited to, the following services:

Durable Medical Equipment and Medical Supply Services Practitioner Services Prescribed Drug Services Assistive Care Services Home Health Services Developmental Disabilities Services Project AIDS Care Waiver Services Mental Health Targeted Case Management

• Therapy Services • Independent Laboratory

Services • Freestanding Dialysis

Center  

Upcoming MPI Field Initiatives

During the upcoming field initiatives, Agency staff will determine if providers are rendering, billing, and documenting services in accordance with Medicaid policy and laws.  Any quality of care issue identified during field operations will be referred to the appropriate regulatory entity.  Additionally, MPI will continue to collaborate with the various Managed Care Organizations in oversight activities to ensure providers in their network are complying with Medicaid policy and providing all of the required necessary services to Florida’s Medicaid recipients.

Fall 2015 Florida Medicaid Provider Bulletin

Now Available

Published October 5, 2015 Florida Fall 2015 Medicaid Provider Bulletin

FloridaHealthFinder.gov Webinar

Sign up for an informative 30 minute webinar demonstration of the many resources available to providers on FloridaHealthfinder.gov. A brief Q&A will follow the presentation. Please register for FloridaHealthFinder.gov Webinar on Oct 29, 2015 10:00 a.m. ET at:

https://attendee.gotowebinar.com/register/6307344424746051585In order to access the audio portion of the webinar, you must dial 1-888-670-3525 and enter the code 900 967 2762#.

AHCA Health IT Symposium: Helping Florida Get Connected

November 12th (Jacksonville, FL)12:00 – 4:30 p.m. EDT

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 concerns, and practical applications of Health IT services. Register here.

Click here to see which industry leaders are participating.

Florida Medicaid Incentive Program

October/November News Bytes

The Final Rule for 2015 proposed modifications to the Electronic Health Record Incentive Program

HTH will help you find it…

Florida Medicaid Readiness and Training

AHCA Public Meeting Calendar

AHCA Registration for Area-Specific September ICD-10 Training

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

Medicaid.gov ICD-10 Changes from ICD-9

Staywell/Wellcare of Florida ICD-10 Compliance

• Sunshine Health ICD-10 Overview

• Prestige Nov Provider Training:

Staywell: ICD-10 Resources

Helpful Hints to Navigation ICD-10 Claim Edits   

*Click on link, then click “open” for PDF

Sunshine Health: 2015 Provider Anti-Kickback Training Webinars

Sunshine Health’s Provider Partnership Management team is hosting provider Anti-Kickback training webinars for participating providers.

The webinars include:Core of the Anti-Kickback StatuteRemunerationFines & PenaltiesHow to Report Violations Sunshine Health

Webinar Schedule:

Wednesday, November 11th, 2015:Go to https://centene.webex.com/centene/k2/j.php?MTID=t1718c38e32f0df556285c928ca80d708 and register.

Friday, December 11th, 2015:Go to https://centene.webex.com/centene/k2/j.php?MTID=t520a825477f4dbfd5abb419c8f8840a0 and register.

Webinar Information

HomeTown Health Florida Medicaid Informationhttp://hthu.net/flex-grant/florida-medicaid-webinars/

Launch Poll Question

HomeTown Health Help Desk

THANK YOU!