Commonwealth of Massachusetts Executive Office of Health and Human Services Office of Medicaid 600 Washington Street Boston, MA 02111 www.mass.gov/masshealth MassHealth School-Based Medicaid Bulletin 16 September 2008 TO: School-Based Medicaid Providers (formerly Municipally Based Health-Care Providers) Participating in MassHealth FROM: Tom Dehner, Medicaid Director RE: Change of Program Name of Municipal Medicaid to School-Based Medicaid; Continuation of Administrative Activity Claiming (AAC); and an Introduction to the Random-Moment Time Study Change of Program Name MassHealth is changing the name of the Municipal Medicaid Program to the School-Based Medicaid Program. The name change is intended to better reflect the nature of delivery of services furnished through this program. However, this name change does not reflect any change in the existing nature of the program. Provider agreements, MassHealth guidance, and any other documents produced by MassHealth or its contractor, the University of Massachusetts Medical School (UMMS), that refer to the Municipal Medicaid Program apply to the School-Based Medicaid Program. Continuation of AAC In March, 2008, MassHealth sent a bulletin announcing the elimination of Program the Administrative Activity Claiming (AAC) portion of the School-Based Medicaid Program in response to a newly promulgated federal Medicaid rule (CMS 2287-F). That federal rule has been placed under a congressional moratorium until April 1, 2009. As a result, MassHealth will not eliminate the AAC portion of the School-Based Medicaid Program at this time. MassHealth will keep providers informed of further developments regarding the AAC program. Random-Moment Time MassHealth will replace the 15-minute increment time study with a Study and Administrative random-moment time study (RMTS). Participation in the RMTS is Activity Claiming required in order to complete and submit AAC claims for activities that occur on or after October 1, 2008. Participants in the RMTS were required to provide UMMS, which is the program administrator for the School-Based Medicaid Program, with requested information by September 15, 2008. If you have not provided UMMS staff with the name, phone number, and email address for an individual who will be the RMTS contact for your organization, please do so by contacting UMMS by telephone at 1-508-856-7640 or via e-mail at Schoolbasedclaiming@umassmed.edu. Incorporating RMTS The methodology for calculating the AAC-reimbursable amount for Results into AAC Claims activities that occur on or after October 1, 2008, will remain the same as is described in the Claiming Manual for School-Based Administrative Activities, July 1, 2005, except that the results of the RMTS will replace the results of the 15-minute increment in the calculation. UMMS will compile results of the RMTS on a statewide level. These results will then be distributed to each school-based Medicaid provider each quarter for use in the AAC calculation. More information on the process that will be used to distribute RMTS results to school-based Medicaid providers will be forthcoming. RTMS and Direct- MassHealth is developing a new direct-service claiming (DSC) Services Claiming reimbursement methodology. As proposed, this new methodology would use results from the RMTS in calculating the DSC claim amounts. In order to ensure that there is no lapse in the ability to claim for direct services once the new DSC reimbursement methodology is implemented, school-based Medicaid providers should ensure that they are included in the RMTS beginning October 1, 2008. As stated above, if you have not provided UMMS staff with a RMTS contact from your organization and you wish to participate in the DSC portion of the School-Based Medicaid Program, please do so by contacting UMMS by telephone at 1-508-856-7640 or via e-mail at Schoolbasedclaiming@umassmed.edu. MassHealth will communicate further details about changes to the DSC reimbursement methodology as they become available. In the meantime, providers should continue to use the current billing codes. Questions If you have any questions about the information in this bulletin, please contact UMMS at 1-508-856-7640 or e-mail your inquiry to Schoolbasedclaiming@umassmed.edu. . MassHealth School-Based Medicaid Bulletin 16 September 2008 Page 2