Health Initiatives : MCAC BZ Giese, RN July 16, 2013
HeART Initiative - Charleston Promise Neighborhood (CPN) • SCDHHS is working with CPN and IFS to review data and Medicaid eligibility within their four schools: James Simons Elementary, Sanders-Clyde Creative Arts, Mary Ford Elementary, and Chicora School of Communications • SCDHHS will help facilitate a shared eligibility worker for the 4 CPN schools and possibly the entire Charleston County School District • SCDHHS will offer a training session on How To bill Medicaid for the service provider • CPN hiring a Nurse Practitioner 8/1 2
HeART Initiative - Charleston Promise Neighborhood (CPN) • SCDHHS is developing a turn-key packet to describe the sustainability model for other schools in the state to replicate from start to finish • Model supports PCMH concept by ensuring the primary care practice receives school/NP report of each visit • CPN and SCDHHS will partner to host a fall health fair to engage parents and the community in the CPN program while encouraging Medicaid enrollment 3
Obesity SPA to recognize Licensed Dietitians as a new provider type is currently under review by CMS On June 20 th SCDHHS hosted an external stakeholder meeting to review our current status on obesity. Attendees included but not limited to MCO/MHN’s, LD’s, and Physicians Clemson/MMIS and MCO aligning systems for payment *Physicians will utilize two codes: G Code Modifier Service Per Fiscal Year G0402 U5 Initial Preventative physical exam provided by a Practitioner 1 G0402 U6 Subsequent Preventive service provided by a Practitioner 5 *After 6 visits SCDHHS will require internal medical review The provider will be required to use the 5A’s as recommended by the US Preventative Task Force during the initial exam – Assess, Advise, Agree, Assist, Arrange 4
Obesity Licensed Dietitians will utilize two codes: S Code Service Per Fiscal Year S9470 Nutritional counseling, dietitian visit service provided by a licensed dietician 1 Nutrition classes, non-physician provider, per session service provided by a S9452 licensed dieticians 5 *After 6 visits SCDHHS will require internal medical review ICD-9 codes listed below must be included with the G code or S code to monitor and evaluate a patient’s progress through tracking their Body Mass Index Program Participation starts at BMI of <30 V85.30 BMI 30.0-30.9 V85.36 BMI 36.0-36.9 V85.31 BMI 31.0-31.9 V85.37 BMI 37.0-37.9 V85.32 BMI 32.0-32.9 V85.38 BMI 38.0-38.9 V85.33 BMI 33.0-33.9 V85.39 BMI 39.0-39.9 V85.34 BMI 34.0-34.9 V85.40 BMI 40.0-44.9 V85.35 BMI 35.0-35.9 5
Obesity • SCDHHS in final review of a How to Enroll as a Medicaid Provider (will apply to all providers and on website) • SCDHHS is working closely with the SC Academy of Nutrition and Dietetics during this process and creating a list of all LD’s • SCDHHS to initiate a statewide education campaign with provider offices throughout the state • Anticipated launch date: October 1, 2013 6
Recommend
More recommend
