HomeMy WebLinkAboutResolutions - 1996.05.23 - 24838MAY 9, 1996
MISCELLANEOUS RESOLUTION #96110
BY: PUBLIC SERVICES COMMITTEE - SHELLEY TAUB, CHAIRPERSON
IN RE: COMMUNITY MENTAL HEALTH - EARNED REVENUE CONTRACTS WITH
THE MICHIGAN DEPARTMENT OF MENTAL HEALTH
To the Oakland County Board of Commissioners
Chairperson, Ladies and Gentlemen:
WHEREAS the Michigan Department of Mental Health has
requested approval of "Earned Revenue" contracts with the Oakland
County CMH Board for the periods 8/1/95 - 9/30/95, 10/1/95 -
12/31/95 and 1/1/96 - 9/30/96, to provide for reimbursement of
CMH costs for pre-admissions and continued stay reviews of
inpatient and day hospital services under the State's Medicaid
Managed Care program; and
WHEREAS approval of these contracts is necessary in order
for the revenue earned by the Board since August 1, 1996 to be
received from the Department of Mental Health; and
WHEREAS the terms of the proposed Earned Revenue Contracts
have been reviewed by Oakland County Corporation Counsel and are
acceptable to the Administration with modification of the 8/1/95
- 9/30/95 and 10/1/95 -12/31/95 agreements to make the language
on page 4, 111.B, fourth sentence consistent with the newer
1/1//96 - 9/30/96 agreement, i.e., "In the event that the BOARD
realizes costs incurred after the billing has been submitted for
a month, or corrections need to be made to a submitted billing,
the Board may submit a revised billing that replaces the billing
previously submitted".
WHEREAS these contracts have been approved by the Oakland
County Community Mental Health Board.
NOW THEREFORE BE IT RESOLVED that the Oakland County Board
of Commissioners approves the three attached agreements with the
Michigan Department of Mental Health as modified.
Chairperson, on behalf of the Public Services Committee I
move the adoption of the foregoing resolution.
PUBLIC SERVICES COMMITTEE
'AGREEMENT
between
THE MICHIGAN DEPARTMENT OF MENTAL HEALTH
AND
THE COMMUNITY MENTAL HEALTH BOARD
This AGREEMENT is made by and between the MICHIGAN DEPARTMENT OF MENTAL
HEALTH, hereafter referred to as the "DEPARTMENT and the
COMMUNITY MENTAL HEALTH BOARD,
hereafter referred to as the 'BOARD', to tie effective from August 1, 1995, through
September 30, 1995.
I. PURPOSE
This agreement is intended to specify the requirements for Medicaid reimbursement
for the completion of PRE-ADMISSION SCREENINGS FOR NON-STATE
HOSPITAL PSYCHIATRIC INPATIENT SERVICES, and PRE-ADMISSION
SCREENINGS AND CONTINUING STAY REVIEWS FOR HOSPITAL-BASED
PARTIAL HOSPITALIZATION PROGRAMS, AND RELATED MEDICAID
MANAGED CARE ACTIVITIES, including the method of costing, billing and
payment for these services.
REQUIREMENTS
A. Screenings and reviews as described herein shall be conducted and
reported in accordance with the following documents:
•
1. Medicaid Services Administration (MSA) Bulletin 95-02, for Mental
Health Clinics, issued July 1, 1995.
2. Federal OMB Circular A-87, "Cost Principles for State, Local and
Indian Tribal Governments," dated Wednesday, May, 17, 1995.
3. Requirements for the Medicaid Managed Mental Health Services
Program, Inpatient Pre-Admission Screening Procedures, Partial
Hospitalization Review Procedures, and Utilization Management
Criteria - Level of Care Determination, distributed by the
DEPARTMENT.
1
4. Quality Improvement and Performance Monitoring Plan for Managed
Mental Health Services Program, distributed by the DEPARTMENT.
The DEPARTMENT will notify the BOARD of any changes in these
documents due to federal or state requirements. Such changes will be
incorporated into this Agreement within sixty (60) days of the
DEPARTMENT's notification to the BOARD, unless otherwise provided by
federal regulations.
INPATIENT PRE-ADMISSION SCREENING
B. The BOARD will provide pre-admission screening for Medicaid recipients not
enrolled in a capitated health plan, requesting or presented for admission to
a psychiatric hospital or psychiatric unit. Pre-admission screening activities
are defined as:
Staff activities to conduct a brief assessment to determine whether or
not psychiatric inpatient is the appropriate level of care. This may
include staff travel time for face-to-face screenings.
This does not include: comprehensive assessments or evaluations;
referral activities; involuntary petitions/applications; court work; or
certifications.
Inpatient services must be coordinated with the Michigan Peer Review
Organization (MPRO) which is responsible to authorize Medicaid payment
for the inpatient stay.
PARTIAL HOSPITAUZATION SCREENING AND AUTHORIZATION
C. The BOARD will provide pre-admission screening, episode management,
and retrospective reviews for Medicaid recipients not enrolled in 'a capitated
health plan, who request or are referred for Partial Hospitalization Programs
(PHP).
Pre-admission screenino a arnersons wno are CM( etnea 1T1 PHF
into an alternative service are defined as:
Staff activities to conduct a brief assessment to determine whether or
not a PHP is the appropriate level of care. This does not include:
comprehensive assessments or evaluations; or referral activities.
IJ Dr DE Disoae manauerner admitted to a i includes the
pre-admission screening, continuing stay reviews and payment authorization
activities associated with an episode of service in a PHP. These are defined
as:
Pre-admission screening: Staff activities to conduct a brief
assessment to determine whether or not a PHP is the appropriate
level of care.
Continuing stay reviews: Staff activities conducted at intervals
following admission, to determine whether further PHP service is
needed.
Payment authorization: Staff activities to notify the PHP and/or the
Medical Services Administration (MSA) regarding the number of days
of PHP service which are approved for Medicaid payment.
Retrospective reviews for persons admitted to PHP are defined as:
Staff activities to review the entire PHP medical record to determine
whether or not the admission was appropriate, whether some or all of
the days of care were appropriate for Medicaid payment, and to
authorize the Medicaid payment.
RECONSIDERATIONS AND APPEALS
D. The BOARD will provide for a reconsideration of a decision which it renders
regarding (1) request for psychiatric inpatient admission, (2) request for
admission to, or payment authorization for, a PHP. Reconsideration
activities are defined as:
Time spent by the clinical supervisor or CMH psychiatrist in reviewing
the documentation of the CMH clinician's decision; time spent in
obtaining additional information from the person requesting
reconsideration; time spent rendering and documenting the
reconsideration decision.
E. The BOARD will participate in Department of Social Services (DSS) hearings
for appeals of decisions which it renders regarding (1) request for
psychiatric inpatient admissions, (2) request for admission to, or payment
authorization for, a PHR Appeal activities are defined as:
Time spent by clinical staff/supervisor or Community Mental Health
(CMH) psychiatrist in a DSS hearing.
3
S-
OUT OF STATE
F. The BOARD will provide pre-admission screening and prior admission
authorization for children referred for out-of-state psychiatric inpatient
placements. Pre-admission reviews are conducted in accordance with
Under 21 Elective Admission Certificate of Need requirements:
Time spent by CMH clinicaVmedical staff in conducting pre-admission
review and in submitting Medicaid payment authorization
documentation to DSS/MSA and the treating facility.
G. The BOARD will provide continued stay reviews and Medicaid payment
authorization for children's out-of-state psychiatric inpatient placements.
Continued stay review activities are defined as:
Time spent by CMH clinical staff in conducting continued stay reviews •
and in submitting Medicaid payment authorization documentation to
DSSIMSA and the treating faaility.
III. RECORDS, BILLINGS AND REIMBURSEMENTS
A. The BOARD will maintain all documentation and records concerning
activities performed, and verification of compliance with standards for
subsequent audit, and actual cost documentation for a period of seven (7)
years and assure that all such documents will be accessible for audit by
appropriate DEPARTMENT staff and other authorized agencies.
B. The BOARD will submit monthly billings to the DEPARTMENT for activities
performed in accordance with the terms of this Agreement. Billings will be
on an actual cost basis, as defined in the DMH billing procedures for
Medicaid Managed Mental Health Care. Only one (1) bill for all the various
activities performed under this contract will be considered for payment per
month, and should be submitted to the DEPARTMENT within forty-five (45)
days after the end of the month in which the activities were performed,
except for the September bill which should be submitted within fifteen (15)
days after the end of the month. In the event that the BOARD realizes costs
incurred after the billing has been submitted for a month, the Board may
submit a revised billing. In any event, all bills for services provided under
this Agreement must be received by the DEPARTMENT no later than
October 15, 1995. Submitted bills will also include separate statements for
each of the types of activities performed, as well as a total bill for the month.
The forms attached to this contract are to be used for billings submitted
under this contract.
4
Payments made to the BOARD for these activities will be included as earned
revenue from the DEPARTMENT on the bi-monthly and final expenditure
reports of the BOARD. Projected revenues will be identified as 'Other
Earned Revenue' on the Summary of Projected Funding, Line 11(E),
0MH/DMH Grants and Earned Contract Totals. No local funds will be
required for the state share of these payments. Payments made under this
Agreement are subject to the requirements under the Single Audit Act of
1984. The CFDA number for the federally-funded portion, which will be
required for the state share of payments made to the Board under the
Agreement, is 93.778.
IV. DEPARTMENT RESPONSIBILITIES
A. The DEPARTMENT agrees that for bills received which are correctly and
completely submitted on a timely basis as specified in Paragraph III. B.
above, payments will be made within forth-five (45) days of receipt of billing
by the BOARD.
The DEPARTMENT will reimburse the BOARD for its actual direct and
Indirect costs for the activities associated with this agreement, up to an
average maximum of:
Inpatient pre-admission screening:
face-to-face: up to $125 per screening
telephone: up to $30 per screening
Partial hospital pre-admission screening where admission is diverted:
face-to-face: up to $95 per screening
telephone: up to $30 per screening
Management of Partial Hospitalization episode where person is
admitted:
up to $220 per episode
Retrospective review: up to $95 per episode
Reconsiderations: up to $50 per reconsideration
Appeals: actual cost per appeal
Out-of-state placement: actual cost per review
5
C. The spending target for the two-month term of this agreement is
attached. PLEASE NOTE that the state has imposed a 5-month
expenditure CAP for the key review activities covered by this
Agreement. The first two months activities/expenditures will be
monitored against the overall limit, but the total CAP will only apply to
the total 5-month period. The key review activities included in the
expenditure CAP are the Inpatient pre-admission screenings and the
partial hospitalization reviews. The activities excluded from the CAP
Include the reconsiderations, appeals, and out-of-state placements.
D. The DEPARTMENT will prepare claims for federal financial participation and
submit these claims to the Department of Social Services. The BOARD will
provide the DEPARTMENT with such documentation as may be required to
support claims for federal financial participation.
The DEPARTMENT will hold the BOARD financially harmless where the
BOARD has followed procedures as outlined in Federal Office of
Management and Budget Circular A--87, and has documentation as to the
activities performed and the costs associated with those activities. The
BOARD will be held responsible for lack of documentation or failure to follow
A-87.
V. TERMINATION
The Agreement may be terminated by either party with sixty (60) days notice. Such
notice shall be made in writing, and sent by certified mail. Termination will take
effect sixty (60) days from receipt of said notice.
Chairperson, Community Mental Health Board Date
James K. Haveman, Jr., Director Date
Michigan Department of Mental Health
Attachments:
A. Medicaid Administrative Activities Earned Contract Maximum Billable Amount.
B. Medicaid Managed Mental Health Care Activity Billing Forms
6
MEDICAID MANAGED MENTAL HEALTH PROGRAM
ADMINISTRATIVE ACTIVITIES
Earned Contract
Board: - Oakland
Direct Service Target:
(Annualized 12 month Amount) $5,118,715
Administartive Activities
(Maximum Billable Amount)
12 Month Maximum Amount $196,731
2 Month Maximum Amount for 8/95-9/95 $32,788
5 Month Maximum A.mouint for 8/95-12/95 $81,971
PEdirlf_A 414 1.11
$125.
$ 95
$ 30
$220
$ 95
FOR MONTHS, , THROUGH
FINAL MONTHLY BILLING FOR MANAGED CARE CONTRACT
I IT
-DEEM
•
MONTHLY ACTUAL COSTS - SEE fOOTNOTE 1 Altlisi LIAX/A11.41 •
r V 1. _ • ,
• 11 ' ' • •
. .
.1,
iNPATiENT PHE ADMISSION/ FACE•TO-FACE
2) INPATIENT PREADMISSION/ PHONE -
13) PHP PREADMISSION/ FACE-TO-FACE
PHP PREADMISSION/ PHONE •
5) PHP EPISODE MANAGEMENT
6) PNP RETROSPECTIVE
7)TOrAL BILLABLE COSTS-SECT1ON ODD LINES I THROUGH 0, COLUMNS)
41) ACCUMULATED TOTAL REIMBURSED COSTS $ _ AND TOTAL UNREIMBURSOKSILLED)COSTS $
proTAL COSTS BILLED TO DATE(ADD UNES 7 AND 5, COLUMNS))
10) CONTRACT CAP
• 1 -• • • - •re., •ff.; 48•••••,8:, ..:f •::lled ,41 ,1 tr.4 1.1' rio 8. 88...4,-4/;.n .'ope,
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I 2)RECONSIDERADONS
131APPEALS
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A/'
as AGREEMENT
. •
between
THE MICHIGAN DEPARTMENT OF MENTAL HEALTH
AND
THE COMMUNITY MENTAL HEALTH BOARD
This AGREEMENT is made by and between the MICHIGAN DEPARTMENT OF
MENTAL HEALTH, hereafter referred to as the 'DEPARTMENT" and the
COMMUNITY MENTAL HEALTH BOARD,
hereafter referred to as the 'BOARD', to be effective from October 1, 1995, through
December 31, 1995.
I. PURPOSE
This agreement is intended to specify the requirements for Medicaid
reimbursement for the completion of PRE-ADMISSION SCREENINGS FOR NON.
STATE HOSPITAL PSYCHIATRIC INPATIENT SERVICES, and PRE-
ADMISSION SCREENINGS AND CONTINUING STAY REVIEWS FOR
HOSPITAL-BASED PARTIAL HOSPITALIZATION PROGRAMS, AND RELATED
MEDICAID MANAGED CARE ACTIVMES, iricluding the method of costing, billing
and payment for these services.
II. REQUIREMENTS
A. Screenings and reviews as described herein shall be conducted and
reported in accordance with the following documents;
•
1. Medicaid Services Administration (MSA) Bulletin 95-.02, for Mental
Health Clinics, issued July 1, 1995.
Federal OMB Circular A-87, 'Cost Principles for State, Local and
Indian Tribal Governments,' dated Wednesday May, 17, 1995 and
OASC-10 'Cost Principles and Procedures for Establishing Cost
Allocation Plans and Indirect Cost Rates for Grants and Contracts
with the Federal Government".
3. Requirements for the Medicaid Managed Mental Health Care
Program, Inpatient Pre-Admission Screening Procedures, Partial
Hospitalization Review Procedures, and Utilization Management
Criteria - Level of Care Determination, distributed by the
DEPARTMENT.
4. Reimbursement Instructions for the Metlicald•Martiged Mental Health
Care Program dated August 1, 1995 distributed by the
DEPARTMENT.
5. Quality improvement and Performance Monitoring Plan for Managed
Mental Health Services Program, distributed by the DEPARTMENT.
The DEPARTMENT will notify the BOARD of any changes in these
documents due to federal or state requirements. Such changes will be
incorporated into this Agreement within sixty (60) days of the
DEPARTMENTs notification to the BOARD, unless otherwise provided by
federal regulations.
INPATIENT PRE-ADMISSION SCREENING
B. The BOARD will provide pre-admission screening for Medicaid recipients
not enrolled in a capitated health plan, requesting or presented for
admission to a psychiatric hospital or psychiatric unit Pre-admission
screening activities are defined as:
Staff activities to conduct a brief assessment to determine whether
or not psychiatric inpatient is the appropriate level of care. This may
include staff travel time for face-to-face screenings.
This does not include: comprehensive assessments or evaluations;
referral activities; involuntary petitions/applications; court work; or
certifications.
Inpatient services must be coordinated with Michigan Peer Review
Organization (MPRO) which is responsible to authorize Medicaid payment
for the inpatient stay.
PARTIAL HOSPITALIZATION SCREENING AND AUTHORIZATION ,
C. The BOARD will provide pre-admission screening, episode management,
and retrospective reviews for Medicaid recipients not enrolled in a capitated
health plan, who request or are referred for Partial Hospitalization Programs
• (PHP).
Pre-admission screening activities for persons who are diverted from PHP
into an alternative service are defined as:
Staff activities to conduct a brief assessment to determine whether
or not a PHP is the appropriate level of care. This does not include:
comprehensive assessments or evaluations; or referral activities.
2
Eisode management. .rjarzi. s a admitted u 2 h H includes the
pre-admission screening, continuing stay reviews and payment authorization
activities associated with an episode of service in a PHP. These am
defined as:
Pre-admission screening: Staff activities to conduct a brief
assessment to determine whether or not a PHP is the appropriate
level of care.
Continuing stay reviews: Staff activities conducted at intervals
following admission, to determine whether further PHP service is
needed.
Payment authorization: Staff activities to notify the PHP and/or the
Medical Services Administration regarding the number of days of
P HP service which are approved for Medicaid payment
/Retrospective reviews for persons admitted to PHP are defined as:
Staff activities to review the entire PHP medical record to determine
whether or not the admission was appropriate, whether some or all
of the days of care were appropriate for Medicaid payment, and to
authorize the Medicaid payment.
RECONS1DEF1ATIONS AND APPEALS
D. The BOARD will provide for a reconsideration of a decision which it renders
regarding (1) request for psychiatric inpatient admission, (2) request for
admission to, or payment authorization for, a PHP. Reconsideration
activities are defined as:
Time spent by the clinical supervisor or CMH psychiatrist in
reviewing the documentation of the CMH clinician's decision; time
spent in obtaining additional information from the person requesting
reconsideration; time spent rendering and documenting the
reconsideration decision.
E . The BOARD will participate in DSS hearings for appeals of decisions which
it renders regarding (1) request for psychiatric inpatient admissions, (2)
request for admission to, or payment authorization for, a PHP. Appeal
activities are defined as:
Time spent by clinical staff/supervisor or CMH psychiatrist in a DSS
hearing.
3
E,
OUT OF STATE
F. The BOARD will provide pre-admission screening and prior admission
authorization for children referred for out-of-state psychiatric inpatient
placements. Pre-admission reviews are conducted in accordance with
Under 21 Elective Admission Certificate of Need requirements:
Time spent by CMH clinicaVmedical staff in conducting pre-admission
review and in submitting Medicaid payment authorization
documentation to DSS/MSA and the treating facility.
G. The BOARD will provide continued stay reviews and Medicaid payment
authorization for children's out of state psychiatric inpatient placements.
Continued stay review activities are defined as:
lime spent by CMH clinical staff in conducting continued stay
reviews and in submitting Medicaid payment authorization
documentation to DSS/MSA and the treating facility.
III. RECORDS, BILLINGS AND REIMBURSEMENTS
A. The BOARD will maintain all documentation and records concerning
activities performed, and verification of compliance with standards for
subsequent audit, and actual cost documentation for a period of seven (7)
years and assure that all such documents will be accessible for audit by
appropriate DEPARTMENT staff and other authorized agencies.
B. The BOARD will submit monthly billings to the DEPARTMENT for activities
performed in accordance with the terms of this Agreement. Billings will be
on an actual cost basis, as defined in the DMH billing procedures for
Medicaid Managed Mental Health Care. Only one (1) bill for all the various
activities performed under this contract will be considered for payment per
month, and should be submitted to the DEPARTMENT within forty-five (45)
days after the end of the month in which the activities were performed. In
the event that the BOARD realizes costs incurred after the billing has been
submitted for a month, the Board may submit a revised billing that replaces
the billing previously submitted. The monthly average maximum will then
apply to the revised billing. In any event, all bills for services provided
under this Agreement must be received by the DEPARTMENT no later than
February 15, 1996. Submitted bills will also include separate statements for
each of the types of activities performed, as well as a total bill for the
month. Th& form attached to this contract is to be used for billings
submitted under this contract.
4
C. Payments Made to the BOARD for these activities will be included as
. earned revenue from the DEPARTMENT on the bi -monthly and final
expenditure reports of the BOARD. Projected revenues will be identified as
*Other Earned Revenue* on the Summary of Projected Funding, Line 11(E),
CMH/DMH Grants and Earned Contract Totals. No local funds will be
required for the state share of these payments. Payments made under this
Agreement are subject to the requirements under the Single Audit Act or
1984. The CFDA number for federally funded portion will be required for
the state share of payments made to the Board under the Agreement Is
93.778.
IV. DEPARTMENT RESPONSIBILITIES
A. The DEPARTMENT agrees that for bills received which are correctly and
completely submitted on a timely basis as specified in Paragraph III. B.
above, payments will be made within forty-five (45) days of receipt of billing
by the BOARD.
B. The DEPARTMENT will reimburse the BOARD for its actual direct and
indirect costs for the activities associated with this agreement, up to an
average monthly maximum of:
(Activities within the Board's target)
Inpatient pre-admission screening:
face-to-face: $125 per screening
telephone: $30 per screening -
Partial hospital pre-admission screening where admission is diverted:
face-to-face: $95 per screening
telephone: $30 per screening
Management of Partial Hospitalization episode where person is
admitted:
$220 per episode
Partial Hospitalization
Retrospective review: $95 per episode
(Activities not within Board's target)
Reconsiderations: $95 per reconsideration
Appeals: actual cost per appeal
Out-of-state placement: actual cost per review
5
4 •••
•
C. The DEPARTMENT ur iilthbZirITi the BOARD up to a 5-month
expenditure CAP . for • the key review activities covered by this
Agreement. The key review activities included In the expenditure CAP
are the inpatient pre-admission screenings and the partial
hospitalization reviews. The activities excluded from the CAP include
the reconsiderations, appeals, and out-of•state placements.
D. The DEPARTMENT will prepare claims for federal financial participation and
submit these claims to the Department of Social Services. The BOARD will
• provide the DEPARTMENT with such documentation as may be required
to support claims for federal financial participation.
E. The DEPARTMENT will hold the BOARD financially harmless where the
BOARD has followed procedures as outlined in Federal Office of
Management and Budget Circular A-87 and OASC-10, and has
documentation as to the activities performed and the costs associated with
those activities. The BOARD will be held responsible for lack of
documentation or failure to follow A-87 and OASC-10.
V. TERMINATION
The Agreement may be terminated by either party with sixty (60) days notice.
Such notice shall be made in writing, and sent by certified mail. Termination will
take effect sixty (60) days from receipt of said notice.
Community Mental Health Board Date
James K Haveman, Jr. Director Date
Michigan Department of Mental Health
Attachments:
A. Medicaid Administrative Activities Earned Contract Maximum Billable Amount.
B. Medicaid Managed Mental Health Care Activity Billing Form
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41. extABLE COSTS-..SECTION I(400 LINES I THROUGH I, COLUMNS)
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DEPARTMENT OF MENTAL HEALTH
LANSING. MICHIGAN 48913
10/1/95
MEDICAID ADMINISTRATIVE ACTIVITIES
EARNED CONTRACT ,
MAXIMUM BILLABLE AMOUNT
Board: Oakland
Administrative Activities:
5 Month Maximum Amount, 8/95-12195 $81,971
AGREEMENT
• between
THE MICHIGAN DEPARTMENT OF MENTAL HEALTH
AND
THE COMMUNITY MENTAL HEALTH BOARD
This AGREEMENT is made by and between the MICHIGAN DEPARTMENT OF
MENTAL HEALTH, hereafter referred to as the *DEPARTMENT" and the
COMMUNITY MENTAL HEALTH BOARD,
hereafter referred to as the 'BOARD", to be effective from January 1, 1996, through
September 30, 1996.
I. PURPOSE
This agreement is intended to specify the requirements for Medicaid
reimbursement for the completion of PRE-ADMISSION SCREENINGS,
CONTINUING STAY REVIEWS, AND RETROSPECTIVE REVIEWS FOR NON-
STATE HOSPITAL PSYCHIATRIC INPATIENT SERVICES, and PRE-ADMISSION
SCREENINGS, CONTINUING STAY AND RETROSPECTIVE REVIEWS FOR
HOSPITAL-BASED PARTIAL HOSPITALIZATION PROGRAMS, AND RELATED
MEDICAID MANAGED CARE ACTIVMES, including the method of costing, billing
and payment for these services.
II. REQUIREMENTS
A. Screenings and reviews as described herein shall be conducted and
reported in accordance with the following documents;
1. Medicaid Services Administration (MSA) Bulletin 95-02 for Mental
. Health Clinics, issued July 1, 1995 and Bulletin 95-06 for Mental
Health Clinics, issued December 1, 1995.
2. Federal OMB Circular A-87, "Cost Principles for State, Local and
Indian Tribal Governments,* dated Wednesday May, 17, 1995 and
OASC-10 "Cost Principles and Procedures for Establishing Cost
Allocation Plans and Indirect Cost Rates for Grants and Contracts
with the Federal Government".
3. Requirements for the Medicaid Managed Mental Health Care
Program, Psychiatric Inpatient Pre-Admission and Episode
Management Review Procedures, Partial Hospitalization Review
‘l
Procedures, and Utilization Management Criteria Level of Care'
Determination, .distributed by the DEPARTMENT.
4. Reimbursement Instructions for the Medicaid Managed Mental Health
Care Program dated January 1, 1996 distributed by the
DEPARTMENT.
5. Quality Improvement and Performance Monitoring Plan for Managed
Mental Health Services Program, distributed by the DEPARTMENT.
The DEPARTMENT will notify the BOARD of any changes in these
documents due to federal or state requirements. Such changes will be
incorporated into this Agreement within sixty (60) days of the
DEPARTMENTs notification to the BOARD, unless otherwise provided by
federal regulations.
INPATIENT PRE-ADMISSION SCREENING, CONTINUED STAY REVIEWS AND
AUTHORIZATION
B. The BOARD will provide pre-admission screening, episode management,
and retrospective reviews for Medicaid recipients not enrolled in a capitated
health plan, requesting or presented for admission to a psychiatric hospital
or psychiatric unit.
Pre-admission screening activities for persons who are diverted from
psychiatric inpatient into an alternative service are defined as:
Staff activities to conduct a brief assessment of Medicaid recipients
who are referred by a source external to CMH for admission to
private psychiatric inpatient services to determine whether or not
psychiatric inpatient is the appropriate level of care. The disposition
of this assessment is to divert the recipient to an alternative service.
Activities may include staff travel time for face-to-face .screenings.
Activities do not include: comprehensive assessments or
evaluations; referral activities; involuntary petitions/applications; court
work; or certifications.
Pre-admission screening activities for persons from another CMH service
area who are assessed as needing psychiatric inpatient services are
defined as:
Staff activities to conduct a brief assessment of a Medicaid recipient
who is from another CMH service area. The scope of such activities
is defined above.
2
i1ul$euj L)IiCt•Crle male k.,mri curing the pre.
admission screening regarding the disposition of the crisis and
regarding which . CMH .will assume responsibility for managing the
inpatient episode.'
Pre-admission screening by the local CMH is to be billed only when
the home CMH has indicated that they will manage the inpatient
episode. If the local CMH conducts the pre-admission and manages
the episode, that activity is to be billed as Inpatient Total Episode
Management.
Inpatient Total Episode Management for persons who are admitted to
private psychiatric inpatient services includes the pre-admission screening,
continuing stay reviews and payment authorization activities associated with
an episode of service in a psychiatric inpatient program. These are defined
as:
Pre-admission screening: Staff activities to conduct a brief•
assessment to determine whether or not psychiatric- inpatient is the
appropriate level of care.
Continuing stay reviews: Staff activities conducted at intervals
following admission, to determine whether further inpatient service
is needed.
• Payment authorization: Staff activities to provide the admission
authorization number and the payment authorization number to the
hospital and/or treating psychiatrist.
Inpatient Total Episode Management cannot be billed until after discharge.
Inpatient Continued Stay Care Management is defined as:
Continuing stay reviews and payment authorization for a Medicaid
recipient from the CMH service area who was assessed as needing
admission through a pre-admission screening conducted by another
CMH. The other CMH will have billed for the pre-admission
screening review.
Inpatient Continued Stay Care Management cannot be billed until after
discharge.
Retrospective reviews for aersons admitted to psychiatric inpatient are
defined as:
Staff activities to review the entire inpatient medical record to
determine whether or not the admission was appropriate, whether
some or all of the days of care were appropriate for Medicaid --
payment, and to authorize Medicaid payment through the issuance
of authorization numbers.
Retrospective reviews are conducted for a person who was either
retroactively enrolled in Medicaid after the end of the episode of
inpatient care, or for whom Medicaid payment for inpatient days of
care is being sought because the recipient's other "primary
insurance failed to cover the entire episode of care.
Inpatient Retrospective Reviews cannot be billed until after discharge.
PARTIAL HOSPITALIZATION SCREENING AND AUTHORIZATION
C. The BOARD will provide pre-admission screening, episode management,
and retrospective reviews for Medicaid recipients not enrolled in a capitated
health plan, who request or are referred for Partial Hospitalization Programs
(PHP).
pre-admission screening activities for persons who are diverted from PHP
inuLsito_alternative sfindg& are defined as:
Staff activities to conduct a brief assessment to determine whether
or not a PHP is the appropriate level of care. This does not include:
comprehensive assessments or evaluations; or referral activities.
Episode Management for persons who are admitted to PHP includes the
pre-admission screening, continuing stay reviews and payment authorization
activities associated with an episode of service in a PHP. These are
defined as:
Pre-admission screening: Staff activities to conduct a brief
assessment to determine whether or not a PHP is the appropriate
level of care.
Continuing stay reviews: Staff activities conducted at intervals
following admission, to determine whether further PHP service is
needed.
Payment authorization: Staff activities to notify the PHP and/or the
Medical Services Administration regarding the number of days of
PHP service which are approved for Medicaid payment.
PHP Episode Management cannot be billed until after discharge.
4
E.; -
_Retrospective Reviews for persons admitted to PHP 'are defined as:
Staff activities to review the entire PHP medical record to determine
whether or not the admission was appropriate, whether some or all
of the days of care were appropriate for Medicaid payment, and to
authorize Medicaid payment through the issuance of authorization
numbers.
Partial Hospitalization Retrospective Reviews cannot be billed until after
discharge.
RECONSIDERATIONS AND APPEALS
D. The BOARD will provide for a reconsideration of a decision which it renders
regarding (1) request for psychiatric inpatient admission or inpatient
payment authorization, (2) request for admission to, or payment
authorization for, a PHP. Reconsideration activities are defined as:
Time spent by the clinical supervisor or CMH psychiatrist in
reviewing the documentation of the CMH clinician's decision; time
spent in obtaining additional information from the person requesting
reconsideration; time spent rendering and documenting the
reconsideration decision.
E. The BOARD will participate in Department of Social Services (DSS)
hearings for appeals of decisions which it renders regarding (1) request for
psychiatric inpatient admission or inpatient payment authorization, (2)
request for admission to, or payment authorization for, a PHP. Appeal
activities are defined as:
Time spent by clinical staff/supervisor or CMH psychiatrist in a DSS
hearing.
OUT OF STATE
F. The BOARD will provide pre-admission screening and prior admission
authorization for children referred for out-of-state psychiatric inpatient
placements. Pre-admission reviews are conducted in accordance with
Under 21 Elective Admission Certificate of Need requirements:
Time spent by CMH clinical/medical staff in conducting pre-admission
review and in submitting Medicaid payment authorization
documentation to DSS/MSA and the treating facility.
5
G. The BOARD will provide continued stay "reviews and Medicaid payment --
authorization for children's out of state psychiatric inpatient placements.
Continued stay review activities are defined as:
Time spent by CMH clinical staff in conducting continued stay
reviews and in submitting Medicaid payment authorization
documentation to DSS/MSA and the treating facility.
RECORDS, BILLINGS AND REIMBURSEMENTS
A. The BOARD will maintain all documentation and records concerning
activities performed, and verification of compliance with standards for
subsequent audit, and actual cost documentation for a period of seven (7)
years and assure that all such documents will be accessible for audit by
appropriate DEPARTMENT staff and other authorized agencies.
The BOARD will submit monthly billings to the DEPARTMENT for activities
performed in accordance with the terms of this Agreement: Billings will be
on an actual cost basis, as defined in the DMH billing procedures for
Medicaid Managed Mental Health Care. Only one (1) bill for all the various
activities performed under this contract will be considered for payment per
month, and should be submitted to the DEPARTMENT within forty-five (45)
days after the end of the month in which the activities were performed,
except for the September bill which should be submitted within fifteen (15)
days after the end of the month. In the event that the BOARD realizes -
costs incurred after the billing has been submitted for a month or
corrections need to be made to a submitted billing, the Board may submit
a revised billing that replaces the billing previously submitted. The monthly
average maximum will then apply to the revised billing.
In any event, all bills for services provided under this Agreement must be
received by the DEPARTMENT no later than October 15, 1996. Submitted
bills will include separate statements for each of the types of activities
performed, as well as a total bill for the month. The form attached to this
contract is to be used for billings submitted under this contract.
Payments made to the BOARD for these activities will be included as
earned revenue from the DEPARTMENT on the bi-monthly and final
expenditure reports of the BOARD. Projected revenues will be identified as
"Other Earned Revenue"' on the Summary of Projected Funding, Line 11(E),
CMH/DMH Grants and Earned Contract Totals. No local funds will be
required for the state share of these payments. Payments made under this
Agreement are subject to the requirements under the Single Audit Act or
1984. The CFDA number for federally funded portion will be required for
the state share of payments made to the Board under the Agreement is
93.778.
6
. I'. s avoi.../ naJr 1./1101b4Ll I ICJ
A. The DEPARTMENT agrees that for bills received which are correctly and
completely submitted on *a timely basis as specified in Paragraph Ill. B.
above, payments will be made within forty-five (45) days of receipt of billing
by the BOARD.
B. The DEPARTMENT will reimburse the BOARD for its actual direct and
indirect costs for the activities associated with this agreement, up to an
average monthly maximum of
Activities within the Board's Expenditure Cap
Inpatient pre-admission screening where admission Is diverted, or a
pre-admission screening for a recipient from another CMH service
area:
face-to-face: $125 per screening
telephone: $30 per screening
Inpatient Total Episode Management:
$220 per episode
Inpatient Continued Stay Care Management Only:
$100 per episode
Inpatient Retrospective Review:
$95 per review
Partial hospital pre-admission screening where admission is diverted:
face-to-face: $95 per screening
telephone: $30 per screening
Management of Partial Hospitalization episode where person is
admitted:
$220 per episode
. Partial Hospitalization
Retrospective review: $95 per episode
Activities not within Board's Expenditure Cat)
Reconsiderations: $95 per reconsideration
Appeals: actual cost per appeal
Out-of-state placement: actual cost per review
7
-
• The DEPARTMENT wilrreimburse the BOARD up to. a 9-month expenditure
CAP for the key review activities covered by this Agreement The key
review activities included in the expenditure CAP are the inpatient reviews
and the partial hospitalization reviews. The ,activities excluded from the
CAP include the reconsiderations, appeals, and out-of-state placements.
The DEPARTMENT will prepare claims for federal financial participation and
submit these claims to the Department of Social Services. The BOARD will
provide the DEPARTMENT with such documentation as may be required
to support claims for federal financial participation.
E. The DEPARTMENT will hold the BOARD financially harmless where the
BOARD has followed procedures as outlined in Federal Office of
Management and Budget Circular A-87 and OASC-10 1 and has
documentation as to the activities performed and the costs associated with
those activities. The BOARD will be held responsible for lack of
documentation or failure to follow A-87 and OASC-10.
V. TERMINATION
The Agreement may be terminated by either party with sixty (60) days notice.
Such notice shall be made in writing, and sent by certified mail. Termination will
take effect sixty (60) days from receipt of said notice.
Community Mental Health Board Date
James K. Haveman, Jr. Director Date
Michigan Department of Mental Health
Attachments:
A. Medicaid Administrative Activities Earned Contract Maximum Billable Amount.
B. Medicaid Managed Mental Health Care Activity Billing Form
8
DEPARTMENT OF MENTAL HEALTH
- LANSING. MICHIGAN 48913
January 31, 1996
MEDICA4MANAGED MENTAL HEALTH SERVICES
Expenditure Targets and Administrative Billing Caps
Board: Oakland
Direct Service Expenditure Target 10/95 - 9196 $5,162,296
Administrative Maximum Billable Cap 1/96 - 9/96 $155,312
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FISCAL NOTE (M.R. #96110)
BY: FINANCE AND PERSONNEL COMMITTEE, SUE ANN DOUGLAS, CHAIRPERSON
RE: COMMUNITY MENTAL HEALTH - EARNED REVENUE CONTRACTS WITH THE
MICHIGAN DEPARTMENT OF MENTAL HEALTH
TO THE OAKLAND COUNTY BOARD OF COMMISSIONERS
Chairperson, Ladies and Gentlemen:
Pursuant to Rule XII-F of this Board, the Finance and Personnel
Committee has reviewed the above referenced resolution and finds:
1. The resolution approves an agreement that allows for full
reimbursement from the State of Michigan for Medicaid
Managed Care activities as defined with the agreement.
2. Some of the services as defined are currently being provided
through the contract for crisis services and the associated
revenue for those services have already been included in the
budget.
3. Upon CMH Board approval of the contract with the Michigan
Peer Review Organization (MPRO) for some of the services
defined in this earned contract, a budget amendment will be
recommended to recognize both the revenues and expenditures
associated with the MPRO contract.
4. Amendments to the Biennial Budget are not recommended at
this time.
FINANCE AND PERSONNEL COMMITTEE
Resolution #96110 May 23, 1996
Moved by Huntoon supported by Devine the resolution be adopted.
AYES: Huntoon, Jacobs, Jensen, Johnson, Kaczmar, Kingzett, McCulloch,
McPherson, Moffitt, Obrecht, Palmer, Pernick, Powers, Schmid, Amos, Crake,
Devine, Dingeldey, Douglas, Garfield, Holbert. (21)
NAYS: None. (0)
A sufficient majority having voted therefor, the resolution was adopted.
STATE OF MICHIGAN)
COUNTY OF OAKLAND)
I, Lynn D. Allen, Clerk of the County of Oakland, do hereby certify that the
foregoing resolution is a true and accurate copy of a resolution adopted by the
Oakland County Board of Commissioners on May 23, 1996 with the original record
thereof now remaining in my office.
In Testimony Whereof, I have hereunto set my hand and affixed the seal of the
County of Oakland at Pontiac, Michigan this 23rd day of May 1
aTir
Lynn D. Allen, County Clerk