Medicaid Made Friendly for Substance Abuse Treatment Providers

1. Medicaid Made Friendly for Substance Abuse Treatment Providers Exploring Revenue Maximization Opportunities and Strategies Mary Herkert mherkert@cfbhn.org

2. Agenda • Multi-System Funding • Medicaid vs Licensure Requirements • Medicaid Substance Abuse Services • Episodes of Care • Medicaid Revenue Opportunities Exercise

3. Identify Populations • Adults • Criminal Justice System • SSI/ Elders • SPMI; Co-occurring DO • Children • Juvenile Justice • Child Welfare • SED/EH; Co-occurring DO

4. Identify Funding Sources & Verify Eligibility MULTI-SYSTEM FUNDING FOR BEHAVIORAL HEALTH SERVICES • Medicaid/Insurance • Managed Care Enrollment • Prior authorization issues

5. Services Crosswalk

6. Services Crosswalk

7. Services Crosswalk

8. Medicaid Covered Services Required by Licensure

9. DCF Licensure related to Medicaid

10. DCF Licensure related to Medicaid

11. DCF Licensure related to Medicaid

12. Medicaid SA Services

13. Medicaid SA Services

14. Reimbursable Services by Episode of Care

15. Reimbursable Services by Episode of Care

16. Reimbursable Services by Episode of Care

17. Reimbursable Services by Episode of Care

18. Reimbursable Services by Episode of Care

19. Potential Medicaid Revenue by Level of Care

20. Medicaid Revenue Opportunity Exercise

21. Medicaid Revenue Opportunity Exercise

22. Medicaid Revenue Opportunity Exercise