Medicaid Program Updates and Best Practices for School Health Supportive Services

1. Preschool/School Supportive Health Services Program 2015 News/Announcements

2. SSHSP News/Announcements • Medicaid Alert #15-04 Clarification of Timely Signatures/Co-signature for “Under the Direction of” (UDO) and “Under the Supervision of” (USO) • Service documentation is required to be completed in a “contemporaneous” manner by Medicaid, which means as close to the conclusion of the session as practicable. • For services provided September 1, 2015 and thereafter, attending provider responsible for UDO/USO must sign/date service encounter documentation no more than 45 (calendar) days following the date of service. • Districts and counties may have a shorter signature/co-signature timeframe policy. Refer to Medicaid Alert #15-04 for more detailed information.

3. SSHSP News/Announcements • ICD-10 Coding (International Classification of Diseases-Tenth Revision) • ICD-10 is an expanded code set. • Claims for dates of service on and after October 1, 2015 require ICD-10 codes. • eMedNY will not publish an ICD-9 to ICD-10 crosswalk: Use the many resources available through https://www.emedny.org/icd to explore your options. • All billing providers who bill Medicaid are impacted: See the FAQs on the eMedNY website to see how your NY Medicaid claims will need to be submitted. • ICD-9 and ICD-10 codes are not allowed within the same claim. • Possible interruption in payment: Submitting claims with ICD-9 codes for dates of services on and after October 1 will be rejected by pre-adjudication edits.

4. SSHSP News/Announcements Medical Orders and Referrals Best Practices • Do not alter an order that has been signed and dated. • Additional information, or clarifications received should be attached. • Example: The ordering or attending professional needed to be contacted to translate the ICD-9 to an ICD-10 code; do not write this on the order – attach it on a separate piece of paper • Required information that is missing from the order can not be added; return the document for the item(s) to be added and re-signed/dated, or obtain a new order. • See p.21-22 of SSHSP Handbook Update #8 for required elements of an order/referral.

5. SSHSP News/Announcements Reminders • Medicaid providers (including SSHSP providers) must complete the revalidation processto continue to bill Medicaid (federal requirement). • There is an annual (December) recertification of Compliance Plans with OMIG for those with claiming activity over $500,000/year. • Parental Consent - “Notification Regarding Use of Public Benefits” letter must be sent annually. • Keep ETIN current for billing through CNYRIC. • Contact RIC representative for “onboarding” training for new staff assigned to SSHSP responsibilities (Medicaid 101). • Affiliatenew attending provider NPIs before claiming.

6. Resources: Medicaid-In-Education Website Sign up on the LISTSERV – Get updates automatically.

7. Resources: Support Services Regional Information Centers (RICs) • Medicaid 101 Training • Documentation Training • Direct support • http://www.oms.nysed.gov/medicaid/contacts/ric_contacts.html Random Moment Time Study (RMTS) and Annual Cost Reporting: • PCG Hotline: 866-912-2974 • NYSSHSP@pcgus.com

8. Resources: Compliance Officer Robert Jake LoCicero, Esq. Deputy Director of Administration NYS Department of Health Corning Tower – Room 2863 Albany, New York 12237 Telephone: (518) 474-9868

9. Resources: State Contacts • NYS DOH - SSHSP Medicaid Policy and Medicaid Claiming Questions • DOH 518-473-2160 • DOH SSHSP Mailbox: SSHSP@health.ny.gov • SED - Provider Support and Training • SED 518-474-7116 • SED Mailbox: medined@nysed.gov