fiscal officers training manual - New York State Conference of Local ...

More documents

Recommendations

Info

At this time, CMS has not yet approved the amendment to NYS’s Medicaid Plan for OMH licensed mental health clinics.As a result, while Part 599 program regulations went into effect on October 1, mental health clinics will not transition toAPG claiming until CMS approval has been received. Once federal approval is received, claims for services deliveredafter October 1 will be automatically reprocessed under APGs.Instructions:OverviewThe plan contains six key elements for reform:1. A redefined and more responsive set of clinic treatment services and greater accountability for outcomes.Clinic is defined as a level of care with specific services. These services will enhance consumer engagement and supportquality assessment and treatment. Clinic treatment will be part of a coordinated and accountable system of recovery andresiliency, which includes other Medicaid reimbursable and non-Medicaid specialty services, such as case management,day and vocational services.2. Redesigned Medicaid clinic rates and phase out of COPs. Medicaid payment rates will be based on the efficientand economical provision of services to Medicaid clients. OMH has established peer groups for payment. Payments willbe comparable for similar services delivered by similar providers across service systems. Payments will also includeadjustments for factors which influence the cost of providing services. The new system will phase out the COPS add-onrate, but clinics will continue to receive CSP. OMH is committed to integrating clinic restructuring with the NYSDepartment of Health’s (DOH) new outpatient reimbursement methodology called APGs (Ambulatory Patient Groups).APGs will replace New York’s current “threshold visit” methodology for reimbursement.3. HIPAA compliant procedure based payment systems with modifiers to reflect variations in cost. The FederalHIPAA Administrative Simplification Act requires the use of a HIPAA compliant billing system. Billing codes for clinicservices will be HIPAA compliant with modifiers to reflect differences in resources and related costs (e.g., early morning,evening and weekend hours; languages other than English; and select services provided by a physician). Additionally, thestate is funding select offsite children’s services and crisis-brief for both adults and children. Claiming for children’s offsiteand crisis-brief offsite will not be done using a modifier; instead a separate rate code will be used. More information willfollow shortly.4. Provisions for indigent care. Article XVII of New York’s Constitution gives the State a special responsibility to care for“persons suffering from mental disorder or defect and [for] the protection of the mental health of the inhabitants”. Assuringaccess to outpatient clinic services is essential to meeting this objective and reducing the demand for other high costservices such as inpatient care. Currently, OMH clinics receiving COPs are required to serve all clients regardless ofability to pay. As part of restructuring, OMH will work to develop a comprehensive strategy for funding mental healthoutpatient services to the uninsured.5. Address Medicaid HMOs/State insurance plan underpayments. Medicaid managed care and, Family Health Plusand underpay for mental health clinic services. To ensure continued access to clinic services, OMH will address Medicaidmanaged care underpayments.6. Standards of Care. OMH recently released standards of care for clinic treatment for adults and children. Theseguidelines are a first step in articulating the basic tenets of good clinical care and accountability. While these have beenlongstanding expectations, they have not been consistently communicated or met.
Resources:1. NYS OMH Clinic Restructuring: https://www.omh.state.ny.us/omhweb/clinic_restructuring/default.html2. NYS OASAS Clinic Restructuring: http://www.oasas.state.ny.us/admin/hcf/APG/Index.cfmDate: May 1, 2011OMH Review: 4/4/11
Page 1 and 2:
FISCAL OFFICERS TRAINING MANUALINTR
Page 4 and 5:
E. Program Budget Change Request (P
Page 6 and 7:
FISCAL YEAR CYCLE (NYC) - STATE DEL
Page 8 and 9:
It is the responsibility of the LGU
Page 10 and 11:
1. To Sign up for Electronic Paymen
Page 12 and 13:
7. NYS Department of Health Medicai
Page 14 and 15:
for the accounting/tracking of the
Page 16 and 17:
c. When a provider’s CSP revenue
Page 18 and 19:
FISCAL OFFICER TRAINING MANUALDISPR
Page 20 and 21:
Business Process: (what is it?):FIS
Page 22 and 23:
4. Return Parts I, II, III and the
Page 24 and 25:
Business Process: (what is it?)FISC
Page 26 and 27:
FISCAL OFFICER TRAINING MANUALFisca
Page 28 and 29: Frequency:The OPWDD deliverables ar
Page 30 and 31: FISCAL OFFICER TRAINING MANUALCOUNT
Page 32 and 33: Note for OMH: Some programs (case m
Page 34 and 35: CountyNEW YORK STATE OFFICE OF ALCO
Page 36 and 37: OASAS: OASAS expects all county ope
Page 38 and 39: Instructions:LGU Splits:The County
Page 40 and 41: o Signed and dated paper copies of
Page 42 and 43: o After all individual service prov
Page 44 and 45: 4. Reconcile, by agency by program
Page 46 and 47: FISCAL OFFICER TRAINING MANUALNYS O
Page 48 and 49: Date: January 25, 2011OPWDD Review:
Page 50 and 51: Business Process: (what is it?)FISC
Page 60 and 61: FISCAL OFFICER TRAINING MANUALSINGL
Page 62 and 63: FISCAL OFFICER TRAINING MANUALUNCOM
Page 64 and 65: 2. NYS Uncompensated Care:https://w
Page 66 and 67: Funding expectancies cannot exceed
Page 68 and 69: Resources:SP Guidelines, Case Manag
Page 70 and 71: • Lodging/Respite/Hotel: Money us
Page 76 and 77: Fiscal activity related to Clinic-P
Page 82 and 83: FISCAL OFFICER TRAINING MANUALMENTA
Page 84 and 85: FISCAL OFFICER TRAINING MANUALADDIT
show all

fiscal officers training manual - New York State Conference of Local ...

Create successful ePaper yourself

Delete template?

Save as template?