MEDICAID UPDATES

1. MEDICAID UPDATES 19th Annual Transportation Disadvantaged Best Practices and Training Workshop  August 2011

2. Policies and Procedures • Contract requires that STPs shall have written policies and procedures for the provision of Transportation Services, as specified in the Agreement. • Commission Policies and Procedures • Will be monitored during 2011/12 Quality Assurance Reviews

3. Medicaid Beneficiary Handbook • Provide to Beneficiary within 7 Calendar Days following determination of a eligibility to receive Transportation Services • Template will be available on CTD Website • Variation must be approved by CTD

4. Encounter Data • Encounter data must be submitted for ALL trips provided • Include trips reported on Trip Travel Expense Report • Must be submitted to support Invoice • Continue to work with Software Vendors • Data is being reviewed for accuracy and completeness • System validations

5. Encounter Data • Issues • Beneficiary Eligibility • Social Security Numbers • Actual Pickup and Actual Drop Off Times • Trip Distance • Trip Cost • Trip Indicator • Trip Mode

6. Encounter Data Beneficiary Eligibility • Use CTDFL • CTDFL data is supplied directly from AHCA • Data may be rejected when submitted to AHCA • Advise CTD of discrepancies with eligibility Social Security Numbers • Must be accurate • Data will be rejected when submitted to AHCA for validation

7. Encounter Data Actual Pickup and Actual Drop Off Times • Times must be reported accurately • Used for on-time performance measures • Use HHMM – 24 hours • Only use “0” for No-Shows Trip Distance • Mileage must be reported accurately • Report “1” mile for Bus Passes

8. Encounter Data Trip Cost • Use Unsubsidized Fully Allocated Cost from Rate Model Worksheets • Include all travel related expenses that are reported on the Trip Travel Expense Report Trip Indicator • Initial, Transfer, Return • Report correctly, all trips can not be initial or return

9. Encounter Data • Trip Mode • Can be confusing because it mixes terminology that overlaps Beneficiary need vs. vehicle type • The best way to explain which TYPE is appropriate is to select the BEST answer (type)

10. Encounter Data • MV -should only be used to reflect trips that are not otherwise included in a more specific category. • PT - door to door paratransit services that are provided by a publicly owned transit system. Examples include 5307 or 5311 subsidized systems that invoice on a per trip or mile basis. You must be able to report passenger miles associated with each trip. • VT - Private Volunteer Transport. • WC - trips where the Beneficiary is in a wheelchair or scooter and cannot transfer themselves from their wheelchair, thereby needing a vehicle that can accommodate a wheelchair/scooter. • ST - trips where the Beneficiary is transported on a stretcher by a specialized stretcher vehicle

11. Encounter Data • OB - Over the road bus (typically thought of as Greyhound) • CA - Commercial Air • BP - single day, multiple days, and monthly passes on a FIXED ROUTE public bus system. Passenger miles for any BP trip must be reported as 1.0 mile. Only report the number of “one-way” Medicaid related passenger trips for which the BP is being used to satisfy. • TX - Any service in a Taxi excluding wheelchair taxis. A Beneficiary in a manual wheelchair who can transfer themselves and their manual fold up chair should be categorized as TX.

12. Best Practices • Utilization of Volunteers • Gatekeeping Strategies • Fixed Route • Customer Service • Reporting • Partnerships

13. Updates • Funding Allocations are being reviewed by the Commission • STP Contracts will be amended shortly to incorporate changes made in Commission’s contract with AHCA • Questions???? Thank you