FLORIDA UPDATES EVELYN LEADBETTER, MPA NETWORK SERVICES MANAGER - PowerPoint PPT Presentation

FLORIDA UPDATES EVELYN LEADBETTER, MPA NETWORK SERVICES MANAGER HOMETOWN HEALTH

OCTOBER  National Breast Cancer Awareness Month  National Domestic Violence Awareness Month  National Cybersecurity Awareness Month SNF QRP: QUICK REFERENCE GUIDE NOW AVAILABLE  https://www.cms.gov/Medicare/Quality-Initiatives-Patient- Assessment-Instruments/NursingHomeQualityInits/Skilled- Nursing-Facility-Quality-Reporting-Program/SNF-Quality- Reporting-Program-Data-Submission-Deadlines.html

ENS REQUIREMENTS FOR LOW INCOME POOL HOSPITALS  The updated requirements include additional event types, data elements, and submission standards and are available online at https://www.florida-hie.net/ens/index.html.  Validation of hospital compliance with the updated ENS participation requirements will occur during the week of November 13, 2017.  Please direct any questions to FLHII@ahca.myflorida.com.

AHCA ANNOUNCES PANEL MEMBERS OF THE PEDIATRIC CARDIOLOGY TECHNICAL ADVISORY PANEL http://www.ahca.myflorida.com/Executive/Com munications/Press_Releases/pdf/PediatricCardiol ogyAnnouncementPR.pdf

FLORIDA MEDICAID END STAGE RENAL DISEASE AND PERITONEAL DIALYSIS WEBINAR  The webinar is scheduled on Tuesday, November 7, 2017 from 10:00 to 11:00 a.m., EST. Please utilize the below link to register prior to the webinar. https://attendee.gotowebinar.com/register/40834 72222155551235

AHCA MONTHLY ACTIONS AHCA Took Licensure Action against 21 Providers, 18 Additional Providers Suspended or Terminated from the Medicaid Program  http://www.ahca.myflorida.com/Executive/Communications/Pre ss_Releases/pdf/AugustMonthlyActions2017.pdf

ASPR TRACIE HTTPS://ASPRTRACIE.HHS.GOV/ Resources on Mass Violence Hurricane Resources and Major Hurricanes: Potential Public Health and Medical Implications Save the Date: November 9 th 2pm-3pm Eastern Register now — space is limited.

HURRICANE IRMA RELATED INFORMATION http://ahca.myflorida.com/MCHQ/Emergency_Activi ties/IRMA_2017.shtml New: UPDATED September 21, 2017 Guidance for Medicaid • Providers Managed Care Plan Hurricane Irma Website Links NEW • Federal Emergency Management Agency Individual • Assistance Programs NEW HHS activates Emergency Program to reimburse • Hospitals NEW

PRESTIGE INFORMATION Click Here for information on HCPCS codes requiring prior authorization 1. Submit a medication prior authorization request to the PerformRx Prior Authorization team by fax at 1-855-829-2871. For any questions, call PerformRx at 1-855-371-3963. 2. The HCPCS code that corresponds to the medication request should be included in the request. If the HCPCS code is a miscellaneous code, the National Drug Code (NDC) number must also be included on the request. 3. PerformRx will then review the request and make a determination within seven calendar days for standard requests and two business days for urgent requests. An approval or denial will be based on prior authorization criteria developed in accordance with current clinical practice guidelines. 4. PerformRx will communicate the final determination to the provider. a. If the prior authorization request is approved, a fax will be sent to your office alerting you of the approval. b. If the prior authorization request is denied, a fax will be sent to your office alerting you of the denial. Also, a letter of denial will be mailed to your office. An additional copy will be mailed to the member.

PRESTIGE PROVIDER TRAINING SCHEDULE Click here for more information

SUNSHINE HEALTH NEWS Providers: Provider Resources October: Building Stronger, Healthier Communities WELLCARE PROVIDER NEWS Provider News

WEBINAR INFORMATION HomeTown Health Florida Medicaid Information: http://hthu.net/florida/