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Showing posts from September 2, 2018

Dear Opioid-Addicted Moms-To-Be, We Are Here for You

Dear Opioid-Addicted Moms-To-Be, We Are Here for You Wednesday, 05 September 2018 By Dr. Sarah Običan, OBGYN, MotherToBaby Florida I feel really lucky. I have had the pleasure and privilege to live and work in some great cities and universities as an OBGYN. I spent my formidable residency years in Washington, DC and loved the diversity of my patients. Being that I was located in the heart of our nation’s capital, in one room I would deliver a princess of some far off nation, in the next, it’d be a dignitary from “the Hill.” But it wasn’t always rosy. Working in such a busy labor and delivery unit meant I would also take care of a 36-week pregnant mother who almost overdosed on cocaine and heroin. The experience was humbling and arguably taught me more about medicine and life than any other. My fellowship years at Columbia University I spent living in Harlem. I brought into the world my first son and delivered him into that beautiful and diverse community. It is a community that’s stro…

Resource for Child Care for Challenging Behaviors

The number one reason that children are “kicked out” of child care settings is due to exhibiting challenging behaviors. Caring for children with challenging behaviors requires a caregiver with knowledge in child development, adaptations to meet the individual child’s needs as well as working with the parents and other community resources. Through the Indiana Partnership for Inclusive Child Care (IPICC) project, IACCRR is committed to assisting providers with resources, on-site technical assistance and resources to reduce the number of challenging behaviors in their setting which results in happier children, staff and families! Inclusion Specialists: There are nine Inclusion Specialists (one in each child care resource and referral agency) to assist providers in caring for children with challenging behaviors. The Inclusion Specialists provide training, on-site technical assistance, resources and other services to assist providers in including children with challenging behaviors. To acce…

IHCP ( Medicaid) revises family member transportation policy

IHCP revises family member transportation policy 

Indiana Administrative Code 405 IAC 5-4-3 permits a family member or close associate of a Medicaid member to be enrolled as a transportation provider for the purposes of reimbursement if the member has to make frequent trips for medical services and those trips would cause an undue financial burden. 

Effective immediately, the Indiana Health Coverage Programs (IHCP) is revising its policy to require family members or close associates enrolled as drivers for Traditional Medicaid members to contract with Southeastrans for mileage reimbursement of nonemergency medical transportation. Although transports by IHCP-enrolled family members and close associates were originally excluded from the brokered services provided through Southeastrans, that is no longer the case. 

To contract with Southeastrans, a family member or associate driver is required to officially enroll with the IHCP as a transportation provider. Family members or associate drive…

Medicaid to reimburse cochlear device separately from outpatient implantation

IHCP to reimburse cochlear device separately from outpatient implantation Effective October 4, 2018, the Indiana Health Coverage Programs (IHCP) will reimburse the cost of Healthcare Common Procedure Coding System (HCPCS) code L8614 – Cochlear device, includes all internal and external components separately from the cochlear implant procedure, when the implantation is performed in the outpatient surgical setting. Separate reimbursement for this device is subject to IHCP coverage policies. 

This change applies to services rendered under the fee-for-service (FFS) and managed care delivery systems for dates of service (DOS) on or after October 4, 2018. 
Beginning October 4, 2018, facility providers may submit claims for separate reimbursement for L8614 on a CMS-1500 professional claim form or its electronic equivalent. The device is priced with a maximum fee rate. Prior authorization (PA) is not required for the device, however PA for implantation continues to be required as is current …

Guide to Medicaid Managed Care Contracting

The National Council for Behavioral Health has released an advocacy guide, Medicaid Managed Care Contracting, to provide community behavioral health providers and associations talking points and sample contract language to use with their state Medicaid agency to ensure Medicaid managed care will enhance behavioral health access.  Even though provider associations cannot engage directly in contract negotiations between states and managed care organizations, they are able to influence state policies and regulations. The guide’s talking points can also be used to strengthen advocacy efforts with state agencies. Access the full guide!

My Health Coverage at–a-Glance! New Customizable Resource from C2C!

CMS’ From Coverage to Care (C2C) has released a new publication for consumers – My Health Coverage at–a-Glance!  In response to community partner requests and feedback, the CMS Office of Minority Health has released a new personalized quick reference resource guide designed for an individual consumer’s particular health coverage.  While insurance cards, member handbooks, and websites have the information we may need, it’s not always easy to find or understand. My Health Coverage at-a-Glance brings those key pieces of information together so consumers have the confidence to use and understand their health coverage to connect to primary care and the preventive services to live a long and healthy life.  Click here to download and print a copy today: https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/MyHealthCoverage.pdf My Health Coverage at–a-Glance is meant to be customized for an individual’s specific health plan. They can complete it on their own, or with a community par…