Indian Health Care Provider (IHCP) Specific Projects. Medicaid Transformation Project and IHCPs April 27, 2018

Similar documents
CENTERS FOR MEDICARE & MEDICAID SERVICES WAIVER LIST

November 2018 Executive Director Report

Medicaid: Overview, Eligibility, and New IHS Encounter Rate Rules

Washington Health Benefit Exchange

THE INDIAN HEALTH CARE SYSTEM IN WASHINGTON STATE. Making it work with few resources and many rules

Medicaid Transformation Demonstration

Financial Executor Portal Q & A

Date: 02/20/15 References: ACWDL# and #15-10 Cross-References: Clerical: Handbook Revision:

President s FY 2016 request is adequate to fund current services but will not due to distribution of the increase

National Council For Behavioral Health: State Medicaid Perspectives on Value-Based Purchasing

North Sound Behavioral Health Organization (For the 2019 North Sound Behavioral Health Administrative Services Organization LLC)

ARRA Medicare and Medicaid Incentive Payments: How will Tribal Health Programs fit in?

Considerations for American Indians in the Health Insurance Exchange. Thursday, September 27, 2012

APPENDIX CHANGES TO APPLE HEALTH CONTRACTS STARTING IN 2017

NPAIHB and ATNI Recommendations on Health Care Reform Policy Options for the Indian Health System 1

CCIIO Marketplace Matrix

Rights and Responsibilities upon Disenrollment

Update on Florida Designated State Health Program Project

Memorandum on CMS Policy Change on 100% FMAP

HCA VALUE-BASED ROAD MAP,

Evidence of Coverage:

Indian-specific Exemptions from ACA Tax Penalty for Not Maintaining Minimum Essential Coverage. Current Status October 22, 2014

Evidence of Coverage:

Medicaid Waivers. National Indian Health Board Annual Consumer Conference. Elliott Milhollin, Partner Hobbs, Straus, Dean & Walker, LLP

Health Reform Legislation and Impact on the Indian Health System

Health Reform Update Medicaid Waivers

Compliance Guide for Tribes and Tribal Health Programs

Presented by Cathy Abramson Chairperson, National Indian Health Board

Advancing Sovereignty. Other ACA and IHCIA-related Topics --

American Indian Health Commission for Washington State

JAMESTOWN S KLALLAM TRIBE FINANCE OFFICE. Presentation to General Citizens September 12, 2009

President Obama proposes $354.1 million increase for Indian Health Service programs

The Definition of Indian Under the Affordable Care Act Approved by the Tribal Technical Advisory Group October 13, 2010

Tribal Sponsorship of Medicare Part B and Part D Premiums 1. November 30, 2017

Medicaid Transportation Statement of Work for Tribal Entity Reimbursement

Impact of the Affordable Care Act (ACA) on American Indians and Alaska Natives: Medicaid and Marketplace Coverage

DRAFT ONLY - Tribal Sponsorship Program Policies and Procedures Checklist

Medicaid Eligibility Factors in 2014

American Indian Health System. Donald Warne, MD, MPH Oglala Lakota

THE NEW YORK STATE DSRIP PLAN: SUMMARY OF KEY ELEMENTS

Disclaimer. The materials and views expressed in this presentation are the views of the presenters and not necessarily the views of Northwell Health

President Obama proposes $354.1 million increase for Indian Health Service programs

MEDICAID EXPANSION & THE MARKETPLACE. American Indian & Alaska Native Specific Provisions

Tables on Referrals and Payment Rates for Services For American Indians and Alaska Natives Enrolled in Marketplace Plans

CENTERS FOR MEDICARE AND MEDICAID SERVICES SPECIAL TERMS AND CONDITIONS. Arkansas Health Care Independence Program (Private Option)

CMS Quality Payment Program

H.R Patient Protection and Affordable Care Act (Enrolled Bill [Final as Passed Both House and Senate] - ENR)

NATIONAL RURAL HEALTH ASSOCIATION

Subpart D MCO, PIHP and PAHP Standards Availability of services.

North Carolina Medicaid Reform Status Briefing

Getting Extra Financial Assistance to Help Pay Health Care Costs

UPDATED BRIEF WITH 2016 DATA

Oklahoma Health Care Authority

Application Provisions

Performance-Based Planning and Programming Why Is It Important? Northwest TTAP and BIA Symposium Portland, OR March 17, 2015

CENTERS FOR MEDICARE AND MEDICAID SERVICES SPECIAL TERMS AND CONDITIONS. Indiana Family and Social Services Administration

CENTERS FOR MEDICARE & MEDICAID SERVICES Creditable Coverage Disclosure to CMS Form Instructions and Screen Shots

National Association of Public Hospitals and Health Systems. Final Rule Regarding Cost Limit for Public Providers and Defining Public Status

March MEDICAID & CHIP Enrollment Service Use & Payments

June 27, The Honorable Mitch McConnell S-230 The Capitol Washington, D.C RE: Tribal Priorities in Senate Healthcare Reform Legislation

Director s Workgroup on Improving Purchased/Referred Care Review

Presentation to the National Advisory Committee on Rural Health and Human Services. February 23, 2011

BHO PROGRAM AGREEMENT

December 20, Submitted electronically via:

Last updated

Self-Governance Health Reform National Outreach and Education. Final Report for Project Year. October 2016

CMS Final Rule: Medicaid Managed Care The Medicaid Mega-Reg

North Central Washington Behavioral Health (NCWBH) C O U R T N E Y W A R D, M P A F I S C A L / C O N T R A C T S M A N A G E R

Dennis G. Shea, Ph.D. Associate Dean for Undergraduate Programs and Outreach Professor of Health Policy and Administration College of Health and

AGEING AND DEVELOPMENT IN BELIZE. Ix-Chel Poot Executive Director National Council on Ageing

Value-Based Purchasing for Managed Long- Term Services and Supports (MLTSS)

MEDICAID REFORM AND THE INDIAN HEALTH SYSTEM

Coordination of Benefits 1

BECOMING BEST FRIENDS: CCBHCs AND DESIGNATED COLLABORATING ORGANIZATIONS. Susannah Vance Gopalan Feldesman Tucker Leifer Fidell LLP March 7, 2016

SCHIP Reauthorization and Indian Health Provisions

MassHealth Section 1115 Waiver Summary. Key provisions:

Medicaid Moving Ahead in Uncertain Times: Findings from the Annual Kaiser 50-State Medicaid Budget Survey

FREQUENTLY ASKED QUESTIONS

Medicaid Eligibility

Washington Health Benefit Exchange

Low-Income Telephone/Broadband Discount Program (Texas Lifeline) Enrollment Form

Congress Passes Final FY 2015 IHS Budget: Despite $208 million increase much less is available for program Increase

Analysis of Affordable Care Act (ACA) Market Stabilization Final Rule 1. April 19, 2017

State Health Reform Assistance Network

Beneficiaries with Medigap Coverage, 2013

WHAT YOU HEARD WE WERE DOING...

Sec moves to amend H.F. No. 3138, the delete-everything amendment. 1.2 (A ), as follows: 1.3 Page 240, after line 13, insert:

POLICY AND PROCEDURE. Department: Compliance. Title: Antitrust Compliance Policy. Effective Date: 2/2017. Annual Review Date: 2/2018.

Transportation Project Selection Process

July 2016 RACIAL/HEALTH EQUITY

South Dakota Health Care Solutions Coalition

SUMMARY: The Bureau of Land Management (BLM) is issuing this final rule to make

CURRENT DEVELOPMENTS IN VALUE BASED PAYMENT (VBP): Part 1 Recent Initiatives

The New York State Value-Based Payment (VBP) Roadmap. Behavioral Health Providers January 30, 2018

BMA Ally Call: Medicare Advantage 2018 Advance Notice and Draft Call Letter. February 8, 2017

The IHS Contract Health Service Program and Medicare-like Rates

November 2016 Teaching Materials

Health Care Reform Reference Guide

Transmittal 75 Date: JANUARY 11, 2001 HEADER SECTION NUMBERS REVISED PAGES REPLACED PAGES (Cont.) (7 pp.) (5 pp.

American Indian/Alaska Native Special Rules and Enrollment Tips

Transcription:

Indian Health Care Provider (IHCP) Specific Projects Medicaid Transformation Project and IHCPs April 27, 2018

Objectives Indian Health Care Providers (IHCPs) will have all foundational information necessary to participate in and benefit from Medicaid Transformation 2

History Washington State applied for a Section 1115 waiver from CMS in August 2015 In January 2017, Washington received approval for up to $1.5 billion This $1.5 billion is spread across three initiatives Transformation through ACHs Long-term Services and Supports Supportive Housing and Supportive Employment 3

Three Initiatives Transformation through ACHs Delivery System Reform Incentive Payment (DSRIP) structure Long-term Services and Supports New Medicaid benefit to support family caregivers Intention is to stop people from impoverishing themselves to qualify for more intensive services Supportive Housing and Supportive Employment New Medicaid benefit to support individuals with need for supportive housing and employment Also referred to as Foundational Community Supports 4

IHCPs Under Initiative 1, IHCPs are eligible to earn approximately $20 million These funds have been approved through the IHCP Protocol, Appendix H of the Special Terms and Conditions The amount is based on percentage of Medicaid beneficiaries identified as AI/AN This is specifically for IHCPs and separate/different than ACH money IHCPs may receive $$ from both ACH project funds and IHCP-specific funds 5

$$ Available to IHCPs IHCP-specific dollars are intended to focus on work not covered or understood by ACHs, such as: CHAP Board Traditional services and healers ACH dollars are constrained by the Medicaid Transformation Toolkit Tends towards more clinically-driven work and each ACH has two required projects: Integration of physical and behavioral services Opioid response 6

IHCP-specific Funds Flow IHCP specific incentive payment funds must be paid in accordance with the instructions received from the tribes and other IHCPs. Tribes and urban Indian health programs agreed that decisions regarding payment of IHCP specific funds will be made by majority vote of tribes and UIHPs, with each having one vote to be held by the AIHC delegate from the tribe or UIHP unless the tribe or UIHP directs that vote to be held by someone else. 7

MTP Year 1: Planning Funds Plan For the first year of Medicaid Transformation (2017), IHCPs earned $5.4 million with the MTP IHCP Planning Funds Plan, submitted 12/29/2017 Tribal and UIHP delegates to AIHC decided that $550,000 would go to the Northwest Portland Area Indian Health Board for establishment of a CHAP Board and the remaining would be distributed equally amongst Tribes and UIHPs ($156,451 each) 8

MTP Years 2-5: IHCP Projects Plan Tribal and UIHP delegates to AIHC will review and vote on the Projects Plan, due October 1, which covers the additional four years of MTP (2018-2021) The Projects Plan will describe who is doing what for what amount of money HCA, with the assistance of AIHC, will work with each tribe and UIHP to develop that tribe s or UIHP s individual Project, which will be part of the Projects Plan 9

$$ for IHCP Projects Plan There is limited funding Eligible Funds 2018: $5.579 million 2019: $3.725 million 2020: $3.320 million 2021: $1.879 million Total: $14.503 million 10

Receiving IHCP-specific Funds Two phase process which covers all of Medicaid Transformation First: Submit the Medicaid Transformation Information Setup Form to Lena Nachand at HCA She will input the information into the Financial Executor Portal Then, the contract person identified on the form will receive an email to complete the registration in the portal This includes bank account information and W-9 information The initial contact person can identify others to have access to the Portal and those people will have read-only access to bank information and W-9 Second: Submit contract information to Holly Jones at HCA She will populate your contract with the information You will then receive the contract to be electronically signed via DocuSign 11

How can the planning funds and projects Only one restriction funds be used? Cannot be used for federal matching opportunities Otherwise, these funds may be used for any purpose HCA encourages capacity building/systems change Participation in AIHC and development of the IHCP Projects Plan and/or ACHs Electronic Health Records Physical Behavioral Health Integration 12

ACH Funds Flow If you have a relationship with the ACH that shares your region, you could be eligible to receive funds from them This would mean working with them to understand their model and system, which HCA can help with We (HCA and AIHC) will be traveling to meet with each individual tribe and UIHP, which could include a meeting with the ACH if you would like 13

Roles of IHCPs, AIHC, HCA and ACHs Tribes and other IHCPs - Receive funds and serve people AIHC - Tribal Coordinating Entity providing technical assistance and support throughout this process HCA - Establish contracts, distribute funds and provide technical assistance ACH - Distribute funds (if contracted) and be a potential resource for regional coordination or items that would benefit from economy of scale 14

Questions? Jessie Dean Tribal Affairs Administrator Office of the Director jessie.dean@hca.wa.gov Tel: 360.725.1649 Lena Nachand Medicaid Transformation Tribal Liaison Office of the Director lena.nachand@hca.wa.gov Tel: 360.725.1386 15