Georgia Department of Community Health Media | Contact Us | Translate | Site Map Search within this site Search About Us Divisions & Offices Programs Providers Publications Budget & Performance Meetings & Notices Home DCH-i January 2012, Vol. 1 Issue 4 DCH-i January 2012, Vol. 1 Issue 4 About DCH-i DCH-i is the monthly newsletter from the Georgia Department of Community Health for all matters DCH. It provides timely and important information to you as physicians, dentists, hospitals, third-party payers, vendors, health care advocates, consumers and legislators. Our goal is to help create A Healthy Georgia -- together. Write us at DCH-i@dch.ga.gov. In This Issue From the Commissioner Ask DCH-i Problem-solving with EHR registration Resource Assistance for Medicaid Members Becoming an SHBP Provider Becoming a Medicaid Provider Medicaid Updates Medicaid/CHIP Redesign Strategic Report Posted Georgia Medicaid's S-CHIP Recevies HHS Bonus Board Rescinds .5% Provider Rate cut Board Repeals PeachCare for Kids Co-Pay 5010/ICD-10 Conversion 68% are Compliant Around DCH For Providers: State Employees Embrace Wellness Initiative New Assisted Living Rules Approved Medicaid EHR Incentive Payments Continue to Climb Update re: PeachCare for Kids/SHBP Health IT Town Hall Highlights Recap of January Board Meeting Upcoming Meetings & Public Comment Opportunities Do you have a question or a comment? A special request, perhaps? Tell us what's on your mind at DCH-i@dch.ga.gov. From the Commissioner Looking Forward: Meeting Challenges, Affecting Changes in 2012 In Governor Deal's State of the State Address last week, he challenged all of us to hold true to "our mission to chart a course that fulfills the priorities of Georgians." Creating A Healthy Georgia is our mission, and as we begin a new year, we renew our commitment to our mission. Medicaid and CHIP Redesign Initiative -- The Medicaid and CHIP Redesign Strategy Report has been posted on our DCH website. The Redesign Initiative was undertaken to help us look at various strategic options geared to improving health outcomes as we achieve long-term program and financial sustainability. The report includes the results of the stakeholder focus group meetings and online surveys, the national and statewide environmental scans, and preliminary recommendations of various delivery options. We will continue to refine our options during the coming months. To provide feedback on the report, visit our website at www.dch.georgia.gov/medicaidredesign or to share a brief comment, e-mail us at MyOpinion@dch.ga.gov. David A. Cook Administrative Simplification -- We at DCH are constantly looking for ways to become more efficient and effective in delivering our core services. As our partners, we greatly appreciate your insights as to how we can do a better job in working with you to achieve our mission of creating A Healthy Georgia. Send your ideas about how can we reduce or eliminate unnecessary and costly administrative rules to DCH-i@dch.ga.gov. State Health Benefit Plan (SHBP) Wellness Plan -- With the introduction of a new Wellness Plan option in 2012, more than 366,000 active employees, retirees and dependents have made The Wellness Promise, making Georgia's wellness program the largest in the nation. Your Wellness Plan patients (under Cigna or UnitedHealthcare) may come to you for a health assessment to gauge their blood pressure, glucose, body mass index and cholesterol. They will ask you to complete and return the member's biometric screening form to the patient's insurance provider before June 30, 2012. Please contact DCH-i@dch.ga.gov if you have any questions or concerns. Health Information Technology (Health IT) -- Health IT holds the promise of transforming our health care delivery system. Health IT programs include the continued adoption of Electronic Health Records (EHR) and the Medicaid EHR Incentive Program, as well as the implementation of our statewide health information exchange. In a public-private partnership with the Georgia Health Information Exchange (GHIE), we will begin connecting existing enterprise and regional health information networks later this year. Healthcare Facility Regulation (HFR) -- HFR continues to protect Georgians by assuring the delivery of safe, accessible, affordable and quality health care services. On the horizon, HFR will continue its geopmapping and electronic simplification for licensing, regulating and inspecting health care facilities across the state. 5010/ICD-10 Update -- Your practice or hospital should already be compliant with the mandatory conversion to 5010/5010A Transaction Standards to ensure timely claims processing. Although CMS has initiated a 90-day grace period for 5010 compliance -- through March 31, 2012 -- DCH urges every provider to move forward with the conversion to 5010, the pre-cursor for ICD-10 code sets. All providers must be compliant with ICD-10 codes by October 1, 2013. Here at DCH, we are dedicated to A Healthy Georgia. Join me as we look forward to a productive and opportunity-filled new year. David A. Cook Commissioner Return to Top Ask DCH-i DCH-i answers your questions each month. If you have an issue, a question or a comment, we'd appreciate hearing from you at DCH-i@dch.ga.gov. Q My federal registration for the Medicaid Electronic Health Record (EHR) Incentive Program is complete, and I've received the confirmation e-mail. However, when I try to register with the state, I have difficulties. Can you help me? A You were correct to first register at the CMS site for the Medicaid EHR Incentives Program. However, please be sure to wait at least 24 hours for Georgia's program to collect and verify your additional eligibility information before proceeding. After 24 hours, please continue your registration using your state's eligibility verification tool. Here's the secure site for registering for the Georgia Medicaid EHR Incentive Program -- http://www.mmis.georgia.gov. To register for the Georgia program as an Eligible Professional, you will need: Your 90-day reporting period for the patient volume calculation. Your patient volume information to determine if you meet the eligibility requirements. The CMS EHR Certification number provided by the Office of the National Coordinator for your certified EHR technology. Documentation supporting adopting, implementing or upgrading (AIU) of certified EHR technology that must be uploaded during the registration process. Please double-check your registration form before submitting. It cannot be processed if it is incomplete. For assistance, please contact Hewlett-Packard (HP) at 1-800-766-4456. Q One of my Medicaid patients has several questions about other Medicaid benefits that we cannot answer. Is there a phone number she could call for some help? A DCH's Constituent Services staff can assist Medicaid patients and other constituents in resolving issues and connecting with resources. Contact the staff at 404-656-4496 or via e-mail at constituentservices@dch.ga.gov. Q Who can I speak with to become an in-network provider for the State Health Benefit Plan (SHBP) in Georgia? A SHBP currently works with two health plan vendors Cigna and UnitedHealthcare. Credentialing is handled by each independently of DCH. Contact Cigna at www.cigna.com or 1-800-88Cigna (1-800-882-4462) and UnitedHealthcare at www.unitedhealthcareonline.com or 1-866-804-3867 to apply to become an in-network provider. Q Who can I speak with to become a Medicaid provider? A Complete information is available at www.mmis.georgia.gov. Click on the Provider Enrollment tab. Hewlett-Packard Enrollment Services' (HPES) telephone number is 1-800-766-4456. Select Option 0, then press Option 4. Return to Top Medicaid Updates Medicaid and CHIP Redesign Strategy Report Posted The Georgia Department of Community Health (DCH) has posted the Redesign Strategy Report. Produced by Navigant Consulting, this report will serve as the foundation for the evaluation of the Recommendation Phase currently underway here at DCH. The report can be found at www.dch.georgia.gov/medicaidredesign. Feedback about the report is being accepted in two preferred ways: detailed survey www.dch.georgia.gov/medicaidredesign or brief comments sent via e-mail to MyOpinion@dch.ga.gov. Georgia Medicaid's CHIP Receives Nearly $5 Million Bonus from HHS The Georgia Department of Community Health (DCH) has received a Children's Health Insurance Plan Reauthorization Act (CHIPRA) bonus of $4,965,887 from the US Department of Health and Human Services/Centers for Medicare and Medicaid Services (HHS/CMS). "Georgia received a performance bonus for the first time," said Medicaid Chief Jerry Dubberly, Ph.D. "The state has made several program improvements to streamline the children's health coverage enrollment process." Georgia met five of the eight required program features set forth in section 210-5 (a)(4) of the Children's Health Insurance Program Reauthorization Act necessary to qualify for a FY11 Bonus Payment. Specifically, the state qualified for: liberalization of the state's asset test, elimination of in-person interview requirements, use of the same application and renewal forms, express lane eligibility, and premium assistance subsidies. As outlined in the statute, states must satisfy two sets of criteria to qualify for a performance bonus: (1) States must have in place at least five Medicaid and CHIP program features known to promote enrollment and retention in health coverage for children; and (2) States must demonstrate a significant increase in Medicaid enrollment among children during the course of the fiscal year. Board Rescinds .5% Provider Rate Cut At its January 12, 2012, meeting, the Board of Community Health voted to rescind the proposed Medicaid provider rate cut of .5% with the following exclusions: hospitals, Federally Qualified Health Centers, Regional Health Clinics, hospice providers, home- and community-based waiver services and nursing facilities. The rescission was introduced at the December 8 board meeting. A meeting for public comment was conducted on December 28, 2011. Board Approves PeachCare for Kids Co-Pays Effective April 1, 2012 The Department will move forward on Co-Payments for PeachCare for Kids for children 6 years of age and older for dates of service on and after April 1, 2012. The co-payments have been rounded down to the nearest dollar or half dollar as a result of public comments received prior to the initial adoption of the Co-Payment Increase for Medicaid and New Co-Payments for PeachCare for Kids, Members Public Notice. Further comments were received at a public hearing on December 28, 2011. The board approved the proposed changes on January 12, 2012. 5010/ICD-10 Conversion - Are You Ready? Although CMS has announced a 90-day grace period to waive penalties for 5010 transaction standard compliance, DCH has already begun processing claims submitted using 5010. More than 68% of DCH's trading partners are already in compliance. All providers must be 5010-compliant as of April 1, 2012, or they will face claims rejections and delays in claims payments from DCH. The 5010 transaction standards transition is the precursor to conversion to ICD-10. When completed by October 1, 2013, the code sets will increase from approximately 18,000 to more than 140,000, allowing for more accurate claims filing and reporting. Return to Top Around DCH State Employees Embrace Wellness Initiative With more than 366,000 members, the State Health Benefit Plan's (SHBP) Wellness program is now the largest in the nation. forward to their insurer. For providers, patients enrolled in one of the SHBP's Wellness Options have agreed to do an online health assessment through their insurer (Cigna or UnitedHealthcare). Additionally, between January 1 and June 30, 2012, they may come to you for their "biometric screening numbers" -- measures of their blood pressure, glucose levels, body mass index and cholesterol. They will have a form with them for you to complete and By selecting a Wellness plan for 2012, these members have signed our Wellness Promise, meaning that they are committed to improving their health. This includes the online health assessment and the reporting of their biometric numbers this year. In Year 2 of the plan, these Wellness members will be working to improve those numbers, becoming even more actively involved in managing their health and wellness. New Assisted Living Regulations Approved At its December 2012 meeting, the Board of Community Health approved new Assisted Living Facility regulations in response to Senate Bill 178. The rules provide for standardization of the application process, ownership and governance, workforce qualifications, emergency preparedness, resident admissions, retention and discharge, residents' rights, as well as other regulatory requirements. "We reviewed best practices and regulations of other states, held Town Hall meetings and formed an informal rules advisory group," said Brian Looby, division chief of Healthcare Facility Regulation. workforce. The rules allow for more choices regarding aging in place by allowing admission and care for residents who need assisted-living services, including the use of certified aids to administer medications. The rules also improve the quality of care by creating new educational requirements for administrators and increasing training and evaluations for the Medical EHR Incentive Payments Continue to Climb Georgia's Medicaid EHR Incentive Program has issued more than $26 million to providers through December 2011. The program was launched on September 5, 2011. Update: PeachCare for Kids SHBP Enrollment As of mid-January, 4,205 dependents from 2,465 State Health Benefit Plan (SHBP) families had enrolled in PeachCare for Kids. This voluntary option is part of the SHBP for 2012. SHBP is continuing to reach out to members about this option to enroll their dependents in PeachCare for Kids through June 30, 2012. Return to Top Health IT Town Hall Highlights Georgia's Health Information Technology (HIT) programs are on target. More than 200 people attended Health Information Technology's Town Hall held at 2 Peachtree in mid-December. Widespread use of health IT throughout Georgia will result in: Kelly Gonzalez Lower health care costs, improved quality of health care delivery and better health outcomes Increased clinician access to information (test results, clinical notes and summaries) Greater coordination and continuum of care and improved patient safety Patients having multi-channel access to their own health information After a warm welcome from Commissioner David Cook, the 90-minute program was moderated by Kelly Gonzalez, interim state HIT coordinator. Other presenters included: James Morrow, MD, Morrow Family Medicine LLC -- Electronic Health Records Dominic Mack, MD, GA-HITREC -- GA Health IT Regional Extension Center Jackie Koffi, Program Director -- Medicaid EHR Incentive Program Kelly Gonzalez and Dennis White, GHIE Inc. -- Statewide Health Information Exchange Jill Girardeau, Womble Carlyle Sandridge & Rice -- HIE Privacy & Security Glenn Pearson, GHIE Financial Committee Chair -- HIE Financial Sustainability Steve Rushing, Georgia Tech -- Consumer-Mediated Health Information Exchange Return to Top Recap of January 2012 Board Meeting The Board of Community Health took the following actions at its January 12 meeting: Unanimously approved for final adoption State Health Benefit Plan Rules (111-4-1-.01, 111-4-1.02, 111-4-1-.04 and 111-4-1-06); Unanimously approved for initial adoption the Nursing Facility Services Public Notice to be published for public comment; Unanimously approved for final adoption the Co-Payment Increase for Medicaid and New Co-Payments for PeachCare for Kids -- Rescission Public Notice; Unanimously approved for final adoption the Provider Rate Cuts -- Rescission Public Notice; Unanimously approved for final adoption New Co-Payments for PeachCare for Kids Members Public Notice and Co-Payment Schedule; Unanimously approved for initial adoption the NOW and COMP Waiver Rate Public Notice (with Rate Schedule) to be published for public comment. View these Resolutions. View these Public Notices. Return to Top Meetings and Public Comment Opportunities Next Board of Community Health Meeting - Thursday, February 8, 2012 - 10:30 a.m. - 2 Peachtree Street, 5th Floor Board Room Proposed Rates for Services provided through the NOW and COMP waiver programs; Final Rate Models - Posted 01/21/12 Nursing Services Re-Notice_January 2012 - Posted 01/12/12 Get News You Can Use Join our mailing list for DCH-i at DCH-i@dch.ga.gov. Editor-in-Chief Pamela A. Keene Graphic Design Karen Rothschild Webmaster Jeffrey Holt Production Iris McIlvaine Circulation Denise Smith Peggy Woodruff Interim Director of Communications About the Georgia Department of Community Health The Department of Community Health (DCH) conducts the business of health care for Georgia. Through effective planning, purchasing and oversight, DCH provides access to affordable, quality health care to millions of Georgians, including some of the state's most vulnerable and underserved populations. DCH is responsible for Medicaid and PeachCare for Kids, the State Health Benefit Plan, Healthcare Facility Regulation and Health Information Technology in Georgia. 2 Peachtree We are dedicated to A Healthy Georgia. Department of Community Health | Site Map | About Us | Adobe Acrobat | DCH Jobs ELECTED OFFICIALS Governor Lieutenant Governor Attorney General More Officials >> AT YOUR SERVICE GeorgiaGov Agencies Cities & Counties Popular Topics ABOUT Privacy/Security Accessibility NEED HELP? 1-800-georgia connect.georgia.gov