Florida Medicaid Update October 2015 Evelyn Leadbetter , MPA HTH Network Services Manager

1. Florida Medicaid UpdateOctober 2015Evelyn Leadbetter, MPAHTH Network Services Manager

2. October AHCA Updates • Florida Medicaid • October ICD-10 Newsletter Now Available In this issue: • ICD-10 is now live! • Email Support • Questions? Find Answers Here • ICD-10 Clinical Concepts Series • CMS ICD-10 FAQ: https://www.cms.gov/Medicare/Coding/ICD10/Frequently-Asked-Questions.html

3. CMS: October ICD-10 FAQ • Coding: • From the Centers for Disease Control and Prevention: Interpretation of Excludes1 notes in ICD-10-CM when the conditions are unrelated to one another.(Posted October 16, 2015)

4. CMS: October ICD-10 FAQ • Coding: • What qualifier do I use for ICD-10 diagnosis codes on electronic claims? (Posted October 16, 2015)

5. https://www.cms.gov/Medicare/Coding/ICD10/ICD-10-Provider-Contact-Table.pdfhttps://www.cms.gov/Medicare/Coding/ICD10/ICD-10-Provider-Contact-Table.pdf

6. Transition of Integral Quality Care Members to Molina Healthcare of Florida, Inc. • Molina Healthcare of Florida, Inc. (Molina) purchased Integral Quality Care’s (Integral) Medicaid line of business.  The Agency for Health Care Administration will transition Integral’s Medicaid membership to Molina effective November 1, 2015.Molina will be issuing new Member ID cards.  All billing and claims reimbursement will be provided by Molina for dates of service beginning November 1, 2015.  All claims for service dates prior to November 1, 2015, must continue to be submitted through Integral and related questions may be directed to Integral’s provider services number at 1-866-258-4326. • Questions related to this transition may be directed as follows:  • Molina Member Services: 866-472-4585 • Molina Provider Services: 855-322-4076 • Website: www.molinahealthcare.com

7. Upcoming MPI Field Initiatives During the remainder of FY 2015-16, MPI intends to conduct site visits to providers of different specialties throughout the state of Florida.  The focus of MPI’s on-site provider reviews will include, but is not limited to, the following services: • Durable Medical Equipment and Medical Supply Services • Practitioner Services • Prescribed Drug Services • Assistive Care Services • Home Health Services • Developmental Disabilities Services • Project AIDS Care Waiver Services • Mental Health Targeted Case Management • Therapy Services • Independent Laboratory Services • Freestanding Dialysis Center

8. Upcoming MPI Field Initiatives During the upcoming field initiatives, Agency staff will determine if providers are rendering, billing, and documenting services in accordance with Medicaid policy and laws.  Any quality of care issue identified during field operations will be referred to the appropriate regulatory entity.  Additionally, MPI will continue to collaborate with the various Managed Care Organizations in oversight activities to ensure providers in their network are complying with Medicaid policy and providing all of the required necessary services to Florida’s Medicaid recipients.

9. Fall 2015 Florida Medicaid Provider BulletinNow Available • Published October 5, 2015 • Florida Fall 2015 Medicaid Provider Bulletin

10. FloridaHealthFinder.gov Webinar Sign up for an informative 30 minute webinar demonstration of the many resources available to providers on FloridaHealthfinder.gov. A brief Q&A will follow the presentation. Please register for FloridaHealthFinder.gov Webinar on Oct 29, 2015 10:00 a.m. ET at:https://attendee.gotowebinar.com/register/6307344424746051585 In order to access the audio portion of the webinar, you must dial 1-888-670-3525 and enter the code 900 967 2762#.

11. AHCA Health IT Symposium: Helping Florida Get Connected • November 12th (Jacksonville, FL)12:00 – 4:30 p.m. EDT Engage with industry leaders, subject matter experts, and Agency for Health Care Administration representatives through panel discussions. This event will unite stakeholders in the exploration of health information technology (Health IT), interoperability of electronic health records, security and privacy concerns, and practical applications of Health IT services. Register here.Click here to see which industry leaders are participating.

12. HTH will help you find it… • Florida Medicaid Incentive Program • October/November News Bytes • The Final Rule for 2015 proposed modifications to the Electronic Health Record Incentive Program

13. Florida Medicaid Readiness and Training • AHCA Public Meeting Calendar • AHCA Registration for Area-Specific September ICD-10 Training • Access CMS Open Door Forum Information and sign up for ODFs here. • Medicaid.gov ICD-10 Changes from ICD-9 • Staywell/Wellcareof Florida ICD-10 Compliance • Sunshine Health ICD-10 Overview • Prestige Nov Provider Training:

14. Staywell: ICD-10 Resources • Helpful Hints to Navigation ICD-10 Claim Edits   *Click on link, then click “open” for PDF

15. Sunshine Health: 2015 Provider Anti-Kickback Training Webinars Sunshine Health’s Provider Partnership Management team is hosting provider Anti-Kickback training webinars for participating providers. The webinars include: • Core of the Anti-Kickback Statute • Remuneration • Fines & Penalties • How to Report Violations Sunshine Health Webinar Schedule: Wednesday, November 11th, 2015: • Go to https://centene.webex.com/centene/k2/j.php?MTID=t1718c38e32f0df556285c928ca80d708 and register. Friday, December 11th, 2015: • Go to https://centene.webex.com/centene/k2/j.php?MTID=t520a825477f4dbfd5abb419c8f8840a0 and register.

16. Webinar Information HomeTown Health Florida Medicaid Information http://hthu.net/flex-grant/florida-medicaid-webinars/ Launch Poll Question HomeTown Health Help Desk

17. THANK YOU!