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Rural Human Services Transportation Coordination in Georgia Workshop

Before KY HSTD Coordination. Fraud

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Rural Human Services Transportation Coordination in Georgia Workshop

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    1. Rural & Human Services Transportation Coordination in Georgia Workshop Human Services Transportation Coordination Governor Steve Beshear, Commonwealth of Kentucky Secretary Mike Hancock, Kentucky Transportation Cabinet Presented by Executive Director Vickie S. Bourne Office of Transportation Delivery Kentucky Transportation Cabinet Monday, August 23, 2010

    2. Before KY HSTD Coordination Fraud & Abuse of Non-Emergency Medicaid Transportation Billings for excessive mileage Ineligible trips No Recipient nor Provider Accountability Escalating Costs No Safety Standards Resource Inefficiency Administrative Operational Need for Greater Mobility

    3. Goals of KY HSTD Accessibility Timeliness Safety Provider/Recipient Accountability Customer Satisfaction Cost

    4. Chain of Events Empower KY Business Case Transportation Cabinet Designated Lead Sponsor KY HSTD Legislation KY State Representative Jimmie Lee State Law KRS 281.870-879 Administrative Regulations 603-KAR 7:080 Joint hearings/statements of considerations

    5. Chain of Events 1. Law 468 (Passed April 14, 1998) All willing and Able Providers 1915(b) waiver - No Freedom of Choice Law 488 (Passed April 6, 2000) Gave Freedom of Choice to all 07’s and 08’s -Covered Services Increase due to Waiver Programs -SCL/ADC adjustments put in Broker Contracts -Transportation to set Sub Rates -Program Coordinator Setup 3. SB 168 - law on escorts March 2003

    6. How the Dollars Flow 1996 – Began Framework for Coordination 1998 – First Broker 2004 – Statewide fully operational Agreements Annual Agreements between State Partners/Transportation Cabinet Finance Cabinet Annual Agreements with Transportation Broker Transportation Broker Agreement Subcontractor

    7. Transportation Broker Concept State Finance Cabinet RFP Awards Broker for each HSTD Geographical Region State Dept of Medicaid Contracts with Transportation Cabinet Determines Eligibility-Funds NEMT Sets a Capitation Payment Rate for each Regional Broker (based on Actuarial Study) State Transportation Cabinet Monitors/Implements Program Collects reports from the Broker

    8. Transportation Broker Concept State Transportation Cabinet Sets Subcontractor Rates Makes Capitation Payment to Broker Conducts assessments/audits Submits reports to Dept of Medicaid Holds Monthly Broker Meetings Testifies to KY Legislative Committees Testifies in Legal Proceedings Meets with other State agencies to make policy or recommend Program changes

    11. Transportation Broker Concept Subcontractor Receives trip pre-authorization from Broker/submits trip data and invoices to Broker Provides Transportation Service Paid by Broker Paid on a Fee for Service Scale Subcontractor pay scale set by Transportation Cabinet (Ky Statute)

    13. Inter-agency Decision Making Body Coordinated Transportation Advisory Council (CTAC) Authority by KY Statute Open to Public Voting members Health and Families Cabinet Workforce Development Transportation Meets Monthly Oversees Progress Program Issues Policy Chain of Events

    14. Executive Quality Management Council (EQMC) Meets Monthly Between Cabinets Draft Policy Take issues to CTAC Develop Quality Improvement Plan Chain of Events

    16. Partners/Funding Source KY Transportation Cabinet Public Transit/Bus System KY Education Cabinet Department of Workforce Investment Office for the Blind Office of Vocational Rehabilitation KY Health & Family Services Cabinet Non-Emergency Medicaid KY Finance Cabinet Tentative Partners Aging and Veterans Group

    17. Transportation Medicaid Specialist

    18. NEMT Factors Affecting Costs 72 Hour Notice Freedom of Choice State Program Coordinators/ Transportation Specialist 800 line/Complaints/Denials Urgent Care Waiver Programs - ADC / SCL Bus Passes Private Autos

    20. Safety/Security Transit on board cameras AVL/MDT Software tracking systems

    23.

    24. UNITED WE RIDE! Kentucky Transportation Cabinet Office of Transportation Delivery Contact: Vickie S. Bourne Executive Director or Jeremy Thompson, Br Mgr 502-564-7433 http://transportation.ky.gov/transportationdelivery

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