Individual provider mental health reimbursement rate increases

Can you give mental health providers any idea on a timeline that the increased rates will be release? Or any ideas on the procedure codes that will be effected?

Informational letter should be going out next week (week of 7-31-23).  There was some sort of an “unintended consequence” with the community mental health centers that needs to be resolved first.

Receiving the increased mental health provider reimbursement rate retroactively

In order to automatically receive the increased reimbursement rates, you do need to bill for an amount that is higher than the current rate.  IME Director Liz Matney suggested that individual mental health providers bill at 60% more than the current rate.  Both Mitch from ITC and Julie from Amerigroup agreed that a 60% higher billing would get you the higher 7-1-23 reimbursement rate.

Another option would be to hold your claims until the new rates are announced and then bill at those rates. Director Matney acknowledged that this could cause a cashflow issue.

If you have already submitted claims at the pre 7-1-23 rates, you can submit claim adjustments for those claims to receive the increased rate that was effective 7-1-23 rate.

Substance Use Disorder Rates

The Informational letter regarding the new Substance use disorder rates went out last week (week of 7-17-23)     Informational Letter 2484

The SUD rate letter was regarding B-3 services which are facility/residential services. I am asking about the outpatient services - like individual and group therapy.

Yes - if you are enrolled as a behavioral health provider those increases will apply

Secondary Claims to Medicare

Has there been any discussion or plan for improvement with Amerigroup and Iowa Total Care regarding the issue with them processing secondary claims to Medicare incorrectly?  We have a significant amount of claims affected by this.  We attempted to contact our reps with no resolution

• please reach out directly to Jeanne.larson@iowatotalcare.com and I will be happy to discuss.
• Amerigroup is also working on the secondary claim issue - please contact Julie Stuhr directly as well  - julie.stuhr@amerigroup.com to discuss your claim specifics

Transportation

Our program, and others we work with, are seeing significant problems with Medicaid transportation services, for all MCO's. Some of the main issues are 1 hour + hold times when calling the schedule client rides and rides frequently not showing up. Are there any solutions we could explore?

Mitch Wasden, ITC:

Globally, transportation seems to be going quite well, but may be issues in specific geographic regions or for specific members. 

If you have any transportation issues you can reach out to me at Mitch.wasden@iowatotalcare.com

Rondine Anderson, Director Provider Services Molina Healthcare

Haven’t yet heard about any transportation issues

              IAProviderRelations@molinahealthcare.com

Amerigroup:

              donna.wendt@amerigroup.com

Elderly Waiver

Hearing lots of complaints with Elderly Waiver taking so long to process by UM and shortened pre-time to 30 days prior in which they can be submitted - leading to individuals losing their Medicaid in the process and then just taking MONTHS before can actually get on the Elderly Waiver.

I am in agreement with Flora and wanted to discuss this today.  Due to the townhall being close to ending, I would like to have a discussion with someone about this issue.  It is really a problem for our older individuals.

Molina

This webpage describes how Medicaid members were redistributed as Molina came on board:

              https://hhs.iowa.gov/ime/mco-onboarding

The best way to reach our case management team is through the case management email you have. This is monitored and responded to continuously throughout the day.

              Get connected with your Molina Provider Services Rep: Contact Us / Rep Map

Molina is still having provider town hall meetings 3 times per week:

Meeting Link to join Provider Town Hall for Molina, M/W/F at NOON:

https://molina.webex.com/molina/j.php?MTID=md7f70639044786c7c0bcb67af3c06593

Mondays  - focus on LTSS

Wednesdays – focus on Behavioral Health

Fridays – focus on Availity (claims system)

Resources for providers

https://www.molinahealthcare.com/providers/ia/medicaid/resources/contact.aspx

Amerigroup

Please reach out to Julie Stuhr, Account Management Director at Julie.stuhr@amerigroup.com  if you have not heard from your specific account manager

Iowa Total Care

Sign up to receive notifications of new newsletters and provider alerts:  https://www.iowatotalcare.com/providers/provider-newsletters.html

         Find our territory maps on our website and don't save the direct links to the maps but save the landing page as they're updated routinely:

https://www.iowatotalcare.com/territory-maps.html

IME Survey of community based providers

The survey for community based services- please complete the survey if you are a case manager, member, caregiver or HCBS provider!

https://surveys.questionprogov.com/a/TakeSurvey?tt=DejBlhAwCIo%3D

To see archival material from this meeting

https://hhs.iowa.gov/ime/about/advisory-groups/townhall/archive

All materials will be posted tomorrow morning (7-28-23)     

If you asked a question that did not did answered during this session, please reach out to us at imetownhall@dhs.state.ia.us.