Quarterly Cost Reports County Treasurers Costs of Direct Services - - PDF document

7/17/2012 1

SCHOOL‐BASED MEDICAID COST SETTLEMENT SYSTEM

July 9, 2012

Quarterly Cost Reports ‐ County Treasurers

Costs of Direct Services – Audiological, Speech, Occupational, Physical, Psychological, Nurses (RNs) Services Costs of Care Coordination – Special Education Teachers (of students with disabilities) Cost of Personal Care – 1:1 Aides Cost of Specialized Transportation

7/17/2012 2

Quarterly Payroll Information

First Name Cost Pool Job Title Employee ID Total Salary Total Benefits Compens ation Federal Sources Net Compens ation Expendit ures John Direct Service Speech Language Pathologist 11111 $25,000 $3,900 $10,000 $18,900 John Care Coordina tion Special Education Teacher 22222 $39,000 $2,300 $42,300 John Personal Care Aide 33333 $12,500 $2,859 $2,500 $12,859

District’s Cost Report

Draft form – will be completed electronically.

7/17/2012 3

District’s Cost Report

Draft form – will be completed electronically.

District’s Quarterly Cost Report

7/17/2012 4

Codes – Accuracy Important

Project Codes: 43310 – IDEA School‐age Funding 43320 – IDEA Preschool Funding Program Function Codes: 21210 Multi‐categorical 2 (Other codes) 2 22161 Occupational Therapy 22162 Physical Therapy 22140 Psychology 22150 Speech/audiology Object Codes: 111 Regular professional (salary) 121 Regular service (salary) 2XX Benefits

Cost Settlement Calculation Example – Neutral

WV: Introduction to Medicaid Cost Based School Based Health Services 8

1.0 Total Costs of Eligible SBHS Provider Costs (county’s cost) $1,000,000 2.0 Indirect Cost Rate 115.00% 3.0 Total Costs of Eligible SBHS Provider Costs $1,150,000 4.0 RMTS Direct Medical Percentage Results (Statewide results) 65.00% 5.0 Direct Medical Services Costs $747,500 6.0 Application of Medicaid Eligibility Rate (IEP Ratio) (county’s) 50.00% 7.0 Medicaid Direct Medical Services Costs (for the county) $373,750 8.0 Medicaid Interim Payments Received (by the county) $373,750 9.0 Medicaid Cost Settlement (at the end of the year – July 2013) $0

7/17/2012 5

Preliminary Results of 1st RMTS February ‐ March

• Response rates – 85% required (3000

moments per “pool”) 92.13% ‐ Direct Services 83.20% ‐ Care Coordination 78.60% ‐ Personal Care 89.47% ‐ Admin

Preliminary Results of 1st RMTS February ‐ March

• Service percentages responses

49.16% ‐ Direct Services 4.24% ‐ Care Coordination 20.21% ‐ Personal Care

7/17/2012 6

PCG’s Time Study Team – “less than appropriate responses were submitted.” PCG will provide a sample of these responses to share with directors to show them the types of responses that are being provided that are adversely impacting the results and potentially the reimbursement.

RMTS Rosters

Rosters of staff in an Excel Template (PCG) ‐ in August 2012 RMTS – October – December 2012 RMTS – January – March 2012 RMTS – April – June 2012