Quarterly Cost Reports County Treasurers Costs of Direct Services - PDF document

7/17/2012 July 9, 2012 SCHOOL ‐ BASED MEDICAID COST SETTLEMENT SYSTEM Quarterly Cost Reports ‐ County Treasurers Costs of Direct Services – Audiological, Speech, Occupational, Physical, Psychological, Nurses (RNs) Services Costs of Care Coordination – Special Education Teachers (of students with disabilities) Cost of Personal Care – 1:1 Aides Cost of Specialized Transportation 1

7/17/2012 Quarterly Payroll Information First Cost Pool Job Title Employee Total Total Compens Net Name ID Salary Benefits ation Compens Federal ation Sources Expendit ures John Direct Speech 11111 $25,000 $3,900 $10,000 $18,900 Service Language Pathologist John Care Special 22222 $39,000 $2,300 $42,300 Coordina Education tion Teacher John Personal Aide 33333 $12,500 $2,859 $2,500 $12,859 Care District’s Cost Report Draft form – will be completed electronically. 2

7/17/2012 District’s Cost Report Draft form – will be completed electronically. District’s Quarterly Cost Report 3

7/17/2012 Codes – Accuracy Important Project Codes: 43310 – IDEA School ‐ age Funding 43320 – IDEA Preschool Funding Program Function Codes : 21210 Multi ‐ categorical 2 (Other codes) 2 22161 Occupational Therapy 22162 Physical Therapy 22140 Psychology 22150 Speech/audiology Object Codes: 111 Regular professional (salary) 121 Regular service (salary) 2XX Benefits Cost Settlement Calculation Example – Neutral 1.0 Total Costs of Eligible SBHS Provider Costs (county’s cost) $1,000,000 2.0 Indirect Cost Rate 115.00% 3.0 Total Costs of Eligible SBHS Provider Costs $1,150,000 4.0 RMTS Direct Medical Percentage Results (Statewide results) 65.00% 5.0 Direct Medical Services Costs $747,500 6.0 Application of Medicaid Eligibility Rate (IEP Ratio) (county’s) 50.00% 7.0 Medicaid Direct Medical Services Costs (for the county) $373,750 8.0 Medicaid Interim Payments Received (by the county) $373,750 9.0 Medicaid Cost Settlement (at the end of the year – July 2013) $0 WV: Introduction to Medicaid Cost Based School Based 8 Health Services 4

7/17/2012 Preliminary Results of 1 st RMTS February ‐ March • Response rates – 85% required (3000 moments per “pool”) 92.13% ‐ Direct Services 83.20% ‐ Care Coordination 78.60% ‐ Personal Care 89.47% ‐ Admin Preliminary Results of 1 st RMTS February ‐ March • Service percentages responses 49.16% ‐ Direct Services 4.24% ‐ Care Coordination 20.21% ‐ Personal Care 5

7/17/2012 PCG’s Time Study Team – “less than appropriate responses were submitted .” PCG will provide a sample of these responses to share with directors to show them the types of responses that are being provided that are adversely impacting the results and potentially the reimbursement. RMTS Rosters Rosters of staff in an Excel Template (PCG) ‐ in August 2012 RMTS – October – December 2012 RMTS – January – March 2012 RMTS – April – June 2012 6