ࡱ> }#` |bjbj 7s3HHHH(((<~~~8~\<dl(:ΗΗΗ̛T,8::::::hj:(<2̛<<:HHΗΗdO<d HΗ(Η8<8@(Η` 42~|̔l//rt $(<<<::d<<<<<<<<<@ D8E9<<@ E<<<HHHHHH   EMBED Word.Picture.8   Introduction: Problem/Opportunity Description The Care Select program is recreating the current Medicaid Select program. The Care Select program will begin 10/1/07 in the Central region of Indiana, and will be phased-in to the rest of the State by or before 7/1/09. New vendor(s) will be procured by approx. 6/1/07 for this program. Since this is a phase-in, each region will have different completion dates. Completion in each region will be determined when the identified population is enrolled in Care Select, and no longer in Medicaid Select. The goal is for the member population is to be either in RBMC, Care Select, duals, spend-down or institutionalized. The regions will be the regions identified in CO910 HLR. One CMO will be selected to also perform Prior Authorization and Medical Policy suspense for the Fee for Service (FFS) population excluding the CS members which will be associated with multiple CMOs. This is a Mod CO because this is adding new or modified functionality to the system. Root Cause of Problem/Opportunity This is a new Managed Care program which will transfer the Medicaid Select population, except for dual eligibles, into a new program called Care Select which will be managed by multiple vendors to ensure appropriate care. Solution Description The fiscal agent, enrollment broker and the Care Management Organization(s) (CMOs) will transfer data to support the assignment of the Care Select members to the CS PMPs. Claims will be processed through IndianaAIM and the CMOs will perform analysis on the data to make informed decisions on administration of the program. Additionally, the CMOs will perform Prior Authorization (PA) There will be one CMO which will be assigned FFS members (including the Medicaid Select members) and two CMOs who will coordinate care for the Care Select Population including PA. Business Impact The vendor(s) will need access and the ability to do data analysis on claims data, prior authorization, provider information, and IndianaAIM information. EDS will need to modify reports and identification markers to be inclusive of the Care Select program and the multiple CMO(s). EDS will also need to ensure that needed reports and information are readily accessible to the new vendor(s). Project Requirements: The system must be modified to identify the covered population for the Care Select Program. The following are eligible recipients for Care Select: IHCP recipients active in one of the following aid categories (formerly Medicaid Select eligible aid categories): MA-A (Aged) MA-B (Blind) MA-D (Disabled) MA-D developmentally disabled (DD) on waiver waiting list (Level of care (LOC) does not apply this subset is not currently systematically identifiable) MA-D DD on HCBS waiver LOCs T, U, V, W Key date for enrolling DD waiver recipients in central region is 10/1/07; members are not restricted from being assigned sooner than 10/1/07 MA-D other HCBS waivers: Waiver AD (LOC A), Waiver MF (LOCs J, X, Y, Z), Note: rolled into A/D for 7/1/06 per OMPP Waiver TB (LOCs K, L), Waiver AL (LOC B), Note: rolled into A/D for 1/1/07 per OMPP Waiver AU (LOC P, Q), Waiver SS (LOC D), Waiver SE (LOC E) Terminated 1/31/07 per OMPP MA-8 (Adoption Assistance) MA-DI (Medworks Improved) MA-DW (Medworks) MA-R (Room and Board Assistance) Home and Community Based Services type for non MA-D Waivers AD, MF, TB, AL, AU, DD, SS, SE, MFC, AL, and SED Corresponding LOCs Regardless of aid category, as long as the aid category is not an exclusionary aid category Hospice non-institutionalized type: LOC codes 51H, 52H, 53H, 54H with no LTC Recipients are eligible if under waiver types W or H for current and future waivers, as long as theyre not one of the excluded categories from requirements 1.2.1 thru 1.2.12. Hoosier Healthwise RBMC-eligible recipients in a low Hoosier Healthwise PMP access county who have not been assigned in at least 30 days of becoming Hoosier Healthwise-eligible are eligible to be assigned to an available and appropriate Care Select PMP. Counties identified in 2/6/07 Milliman executive summary: Clark, Elkhart, Floyd, Hendricks, Montgomery and Tippecanoe counties. Hoosier Healthwise RBMC-eligible recipients in remaining counties throughout the state who have not been assigned in at least 90 days of becoming Hoosier Healthwise-eligible are eligible to be assigned to an available and appropriate Care Select PMP. Source: H1 requirements were reviewed on 3/1/07 and 3/2/07. See HLR for other sources. E-mail from Randy indicated removal of HH potential members. Acceptance Criteria: 1) Test and monitor potential table processing for collecting new Care Select eligibles based on the criteria in 1.1 The following recipients are NOT eligible for Care Select: Recipients on spend-down Recipients dually eligible for Medicare and Medicaid, regardless of aid category Recipients with parts A and/or B. QMBs-Also, SLMBs-Also, QLMBs-Only, and SLMBs-Only regardless of aid category MA-12 (Breast and Cervical Cancer Treatment Services) MA-G (Qualified Disabled Working Individual) MA-I (Qualified individual 1) MA-K (Qualified individual 2) MA-O (Children < 21 in inpt psych facility) MA-Q (Refugee Medical Assistance) Any recipient who has an active institutional-type level of care (nursing home recipients, ICF/MRs, state operated facilities) ARCH and 590 recipients Undocumented aliens MA-3 (Wards) and MA-4 (Foster Children) are eligible for Hoosier Healthwise but shouldnt be excluded from Care Select if another factor makes these children ineligible for Hoosier Healthwise. There are wards/foster children in other aid categories, identified by a ward indicator. Source: H1 requirements were reviewed on 3/1/07 and 3/2/07. See HLR for other sources. Stakeholder review w/e 5/3/07. Acceptance Criteria: Test and monitor the bypassing or deleting of non-eligibles based on the criteria in 1.2 Systematically disenroll Care Select members for the following events: expired IHCP eligibility expired Care Select aid category eligibility (for example, member changes from MA-D to MA-U) member gains Medicare Parts A and/or B member becomes spend-down member becomes institutionalized Hoosier Healthwise-eligible member temporarily assigned to Care Select becomes assignable to a newly available PMP. Reassign temporary Care Select members back to Hoosier Healthwise as soon as PMP availability is determined. May require coordination among EDS, the enrollment broker and the CMO for matching CS-assigned members as HH-assignable, before systematic disenrollment can be defined. member assigned to a Care Select PMP who is disenrolling Source: H1 requirements were reviewed on 3/1/07 and 3/2/07. See HLR for other sources. Acceptance Criteria: Test and monitor systematic Care Select member end dating for scenarios listed in 1.3. Report systematic member disenrollments to the CM vendor(s). See requirements for the 834 transactions. Source: H1 requirements were reviewed on 3/1/07 and 3/2/07. See HLR for other sources. Acceptance Criteria: Refer to 834 requirements Modify the Eligibility Verification Systems (EVS) to report Care Select. Systems include Web interChange, automated voice response (AVR), OMNI machines, and the 270/271 HIPAA enrollment request and response transactions. Identify and report active Care Select membership for date span requested Report members Care Select PMPs name Report members Care Select PMPs 24-hour PMP Service Location phone number Report members Care Select CMO name Report members Care Select CMO phone number for providers Affiliate the members high-level program and benefit package in EVS as currently designed (for example, The member is eligible for Hoosier Healthwise Package A - Standard Plan services from) Source: H1 requirements were reviewed on 3/1/07 and 3/2/07. See HLR for other sources. Acceptance Criteria: Test and monitor accurate EVS responses for Care Select member assignment information listed in 1.5. The system must be modified to assign members to Care Select. Convert applicable Medicaid Select members to Care Select . The program is being phased in throughout the state using managed care region designations. Phase-in members will be identified as a function of their PMPs service location. Identification is based on the PMPs service location in a regional phase-in county. Members assigned to those PMPs will be converted regardless if they also live in a phase-in county or not. During conversion, systematically reassign active Medicaid Select members who meet Care Select eligibility criteria to a Care Select PMP using an auto-assignment type process. Follow the base auto-assignment hierarchy: Previous PMP Previous CMO (technically wont apply) Case ID Default Do not be as restrictive as the 30 mile distance limit in Hoosier Healthwise. Either disregard distance logic for conversion or extend the distance limit to 45 miles Maintain Medicaid Select for dual Medicare/Medicaid members and eligibles who reside in the non phase-in counties Duals in phase-in counties will move to FFS. Maintain original Medicaid Select functionality (eligibility determination, assignment, disenrollment, reenrollment) for members who live in non phase-in counties. Medicaid Select members subjected to conversion assignment but who couldnt be assigned will revert to the potential table with a CS eligible program code, regardless if member resides in or out of the phase in region. Source: H2 requirements were reviewed on 3/1/07 and 3/8/07. See HLR for other sources. Additions to 2.1 from 5/18/07 project status meeting. Acceptance Criteria: Test and monitor manual Care Select assignment execution (2.3), including member location compared to phase-in region (2.1) Generate member assignment letters in addition to assisting in member notifications regarding the new Care Management (CM) vendor(s) and the Care Select Program. For example, generate a member bulletin announcement to non-dual Medicaid Select members living in the Care Select phase-in counties. Generate member welcome letters Self-selections Default auto-assignment Previous relationship Generate member letters when their PMP disenrolls, then reenrolls Generate member letters when their PMP disenrolls but doesnt reenroll Source: H2 requirements were reviewed on 3/1/07 and 3/8/07. See HLR for other sources. Additions to 2.2 from 5/10/07 project status meeting. Acceptance Criteria: Review any EDS-drafted member bulletin information referenced in 2.2 with OMPP for approval. Review and verify CS member letters for correct variable field information, letter forms, and letter language. Support manual assignments, entered by the Enrollment Broker for Care Select eligibles, through a secure system mode Allow for in-plan member PMP in-network assignment changes to be effective various days of the month, depending when updated by the Enrollment Broker. Automatically end-date current PMP assignments affected by PMP changes concurrent to the new assignment Allow assignment of new eligible members entered by the Enrollment Broker to be effective either the 1st or 15th of the month depending when updated Accommodate cross-plan PMP assignment changes, effective the 1st of a month, depending when updated. For example, member wants to change PMPs from CMO1 to CMO2. Will be facilitated by a master enrollment broker for data security. Accommodate cross-plan CMO eligible assignments. For example, member is pseudo assigned to CMO1 for outreach, but prefers to be assigned to a PMP in CMO2. Will be facilitated by master enrollment broker for data security. Source: H2 requirements were reviewed on 3/1/07 and 3/8/07. See HLR for other sources. Modifications to 2.3 from 5/10/07 project status meeting. Acceptance Criteria: Test and monitor manual Care Select assignment execution (2.3) Generate HIPAA-compliant 834 benefit enrollment and maintenance transactions for Care Select members assigned to the CMOs. Identify Care Select program eligibles for access by the Enrollment Broker. The Enrollment Broker currently extracts managed care eligibles via FTP and not through 834s. Continue the current process. Pseudo assign eligibles to the CMOs using an auto-assignment type process that uniquely assigns each Care Select eligible to a CMO. Assignment factors include Previous PMP, Previous Plan, Family participation, and neediest CMO. Report Care Select eligibles to their respective CMOs for outreach and assignment to a PMP. Generate systematic notifications of file transmission success/failure to CMOs and EDS Generate Program Enrollment transactions 3 per month 11th, 26th, and end of month. Report assigned Care Select members to their respective CMOs for data reconciliation Generate systematic notifications of file transmission success/failure to CMOs and EDS Create a new report of Care Select assignees in On-Demand for OMPP and EDS. Source: H2 requirements were reviewed on 3/1/07 and 3/8/07. See HLR for other sources. Modifications to 2.4 from 5/10/07 project status meeting Acceptance Criteria: Care Select eligible transactions, with appropriate eligibility and assignment information, will generate to the CMO based on criteria in 2.4 Hoosier Healthwise and Medicaid Select auto-assignment should cross-compare Care Select assignment history for influence in previous PMP or case ID auto-assignment logic. Care Select auto-assignment should cross-compare Hoosier Healthwise and Medicaid Select assignment history if relevant to the eligible they are assigning in Care Select. Source: H2 requirements were reviewed on 3/1/07 and 3/8/07. See HLR for other sources. Acceptance Criteria: Test and coordinate cross program auto-assignments among Hoosier Healthwise and Care Select PMP assignment histories (2.5 and 2.6) Modify EDSs phone system to include a front end announcement option to allow users to select the Care Select vendor(s). Client services provider calls (example: CMO PMP enrollment) Client services - recipient calls (example: CS member grievance) Create call scripts for customer service and recipient hotline. Track calls for the Care Select Program by each CMO. Initially, track under one general call type- Care Select. May require additional call types as the program develops Acceptance Criteria: Test and monitor Care Select related options added to the EDS phone system Modify recipient subsystem windows in IndianaAIM to reflect Managed Care Entity MCE vs. MCO where relevant for fields that accommodate both Hoosier Healthwise and Care Select. Incorporate the Care Select subprogram value where relevant in IndianaAIMs recipient subsystem windows Source: Internal requirements gathering Acceptance Criteria: Test field headers and values for program changes (2.8 and 2.9) Source: H2 reviewed at 3/8/07 meeting 2.10 Auto-assign Care Select eligibles who have not self-selected their PMP Auto-assign Care Select members to a PMP. The members CMO and region assignment are a function of the PMPs enrollment with the plan(s). Determine Care Select auto-assignment effective dates using the following date scheme: Assignments generated >=11th and <=25th will be effective the 1st of the following mo. Assignments generated >=26th and <=EOM will be effective the 15th of the following mo. Assignments generated >=1st and <=10th will be effective the 15th of the same mo. Care Select auto-assignment hierarchy: PREVIOUS PMP-same service location in previous CMO PREVIOUS PMP-other service locations in previous CMO PREVIOUS PMP-same service location considered in neediest CMO order PREVIOUS PMP-other service locations considered in neediest CMO order PREVIOUS PMP GROUP-same service location considered in neediest CMO order PREVIOUS CMO CASE ID-same PMP service location as family member PREVIOUS CMO CASE ID-same PMP group members as family member PREVIOUS CMO NETWORK, if applicable PREVIOUS CMO-other PMPs CASE ID-same PMP service location as family member CASE ID-same PMP group members as family member DEFAULT (Neediest CMOs PMPs sorted in proximity order) Reassign members still linked to Care Select PMPs who disenroll, then reenroll, in the Care Select program either within the same plan or between plans. Members not previously reassigned by the CMO prior to disenrollment/reenrollment will be subjected to immediate auto-assignment beginning at the previous PMP level. Reassign members in this order: Determine previous CMO, look for previous PMP in that CMO, look for PMPs group in that CMO. If no match continue looking for previous PMP, then previous PMP group, in continued neediest-CMO order. If still no match, look for another PMP, then previous PMP group, in neediest-CMO order Assign restricted card members locked into a PMP participating in more than one CMO in order of the neediest CMO first. If there is no match between restricted (aka locked in) providers and their PMP designations, then return eligible to the potential table. Allow auto-assignments to IFSSA PMP service locations within 30 miles of members residence, but not other OOS service locations. Currently only self-selections can be assigned to OOS designations. Determine a PMPs neediest percentage at each of their sub-panel CMO relationships. Look back 365 days for previous PMP Look back 365 days for previous CMO Look for current Case ID assignments when comparing Case member assignments Auto-assign to PMPs with the following specialties: 314, 316, 328, 344, and 345. Providers enrolled as PMPs in other specialties will receive assignments by self-selection only. Previous PMP and Case ID will override PMP panel hold and panel full designations Integrate geographical assignment capability. Integrate geographical assignment capability Do not auto-assign members more than 45 miles from their residence. GIS automatically scrutinizes PMPs in geographical order by closest first. Do not auto-assign members outside their region even if a PMP outside the region is within 45 miles. Override panel hold and full for previous-PMP or Case ID assignments within 45 miles of a members residence. Implement contingencies if GIS does not recognize an eligibles address: First use the centroid of the eligibles ZIP Code for identifying nearby PMPs Then use ZIP/Quadrant/County logic Hierarchical logic takes precedence over proximity prior to default logic. Neediest CMO takes first precedence in default logic. Proximity of PMP then takes precedence in default logic after neediest CMO determined. Source: Hoosier Healthwise and Medicaid Select auto-assignment algorithms; State of Indianas Indiana Care Select Program Attachment D: Scope of Work; 5/18/07 OMPP CO1037 meeting Acceptance Criteria: Test and monitor system auto-assignment execution and effective dates, as well as appropriate CMO, region and PMP designations. Execute auto-assignment for Care Select eligibles 30 or 60 days from date determined eligible. Shorten the turn-around-time for redetermined Care Select eligibles. Subject Care Select eligibles to auto-assignment without a potential table wait for eligibles who are redetermined within 4 months of their previous IHCP eligibility end date. Source: 5/18/07 OMPP CO1037 meeting Final decision TBD: updated AI log Acceptance Criteria: Test and monitor system auto-assignment kickoff compared to age of potential table record H3 The system must be modified to allow for PMP enrollment and update capability for the Care Select Program. Allow CMO(s) to electronically enroll PMPs via the secure Web interChange. CMO(s) will obtain the States PMP Addendum from the PMP on behalf of the State. Allow the PMPs to be actively enrolled in unlimited service locations for the Care Select program. PMPs will be linked to the CMO vendor ID. PMP providers are identified by the following specialty designations General Internist, Specialty code 344 General Pediatrician, Specialty code 345 Family Practitioner, Specialty code 316 General Practitioner, Specialty code 318 Obstetrics/Gynecology, Specialty code 328 All other specialties listed under Provider type 31- Physician Assumption: Specialty does not have to be the same for a PMPs multiple service locations PMP Scope of practice information will mirror HH and include the following Admit Privileges: Relationship or Privileges Delivery Privileges: Privileges or N/A Age Restrictions 24 hour telephone number and extension Accept Obstetrics indicator: Yes or No All Women (Ob/GYN only) indicator: Yes or No Gender can be male, female or male/female PMPs will continue having maximum panel limits. There are no limitations on panel size. The panel size warning message will continue to appear for users enrolling with panel sizes over 3500. The user will need to confirm and approve the panel size. The panel size must be greater than zero. Certification code will be established for new Care Select PMPs only if the Medicaid Select certification code does not currently exist. Generate certification code letters to newly enrolled Care Select The automated quarterly certification code updates and reports will include Care Select. Assumption: The same certification code will be used for MS and CS with multiple CMO(s). Acceptance Criteria: The requirements listed in 3.1.1-3.1.6. will be tested thoroughly with various PMP scenarios in the Web InterChange-Web enrollment and verified in IndianaAIM and Web InterChange- Provider Profile to ensure logic is functioning as designed. The testing will include verification of generation of new certification code and certification letter. CMO(s) will send a monthly batch of the signature page of the PMP and specialist Addendums to the Fiscal Agent to be maintained in provider file. A business process will be developed to perform the following tasks for the CMO(s) Review the addendums to ensure the addendums are valid Track addendums to ensure received. Provide a monthly report to CMO(s) and State identifying the outstanding addendums. Acceptance Criteria: The business process will identify the PMPs that do not have an addendum on file. The Managed Care unit will coordinate with MCO to ensure the addendums are received. If new provider (non IHCP), the CMO(s) will coordinate with the provider and FA provider enrollment for IHCP enrollment, prior to enrolling as CS PMP or submitting as an ancillary provider in the monthly MCO ancillary file. Acceptance Criteria: Provider enrollment will receive requests for IHCP enrollments and will coordinate with the CMO(s) as necessary. Assumptions CMO users will be tracked to identify who performed the electronic PMP Enrollment. There will not be a way for CMO(s) to submit a file via file exchange to handle ongoing PMP enrollments. Medicaid Select will continue to enroll PMPs through the paper enrollment process. Accommodate out of state (OOS) and IFSSA locations as PMP service locations for Care Select program. Acceptance Criteria: The Web Enrollment testing in requirement 3.1 will include PMPs enrolled in the OOS and IFSSA service locations. Allow PMPs participation simultaneously in CMOs, MCO plans and FFS. Acceptance Criteria: The Web Enrollment testing in requirement 3.1 will include PMPs enrolled with multiple programs. The IndianaAIM-Provider subsystems windows, Web interChange-Provider Profile and IHCP Web site-Provider Search will identify enrolled PMPs to denote that they are a part of the Care Select program and the PMPs applicable CMO(s). Acceptance Criteria: The Web Enrollment testing in requirement 3.1 will include PMPs scenarios that will verify that the PMPs are viewable and accessible in IndianaAIM, Web InterChange and Provider Search. Modify provider subsystems windows to reflect MCE (Managed Care Entity) where referenced as MCO and reference (CS) Care Select as subprogram. Modify PMP Panel window to include Care Select section Remove the following fields and drop-down options from the IndianaAIM PMP Scope of Practice window. (Data no longer captured in Web Enrollment) Remove Field: Families Field: Delivery, Remove drop-down option - Relationship and None Field: Admit, Remove drop-down option - None Acceptance Criteria: Windows will be verified as updated in the approval process of the system testing and UAT. End Date MS PMP service location segments with end date applicable to each Care Select phase-in region completion or as directed by the State. Assumption: Maintain Medicaid Select PMP service location segments until the applicable Care Select phase-in region is completed and MS PMP service location is end dated. Assumption: May be auto assigned to MS members who participate in another region; therefore, PMPs can be dual enrolled in MS/CS. Acceptance Criteria: Reporting will be performed to ensure all Medicaid Select PMP segments have been end dated appropriately. Allow the CMO(s) to update only their contracted PMPs for the following PMP related fields via the secure Web InterChange Admit Privileges Delivery Privileges Obstetrics All Women Age Restriction Telephone Number and Extension Panel Size Panel Size Hold Panel Size Hold Removal Gender Acceptance Criteria: The requirements listed in 3.7. will be tested thoroughly with various PMP scenarios in the Web InterChange-Web update to ensure logic is functioning as designed CMO(s) will not be allowed to electronically disenroll PMPs; EDS will maintain control of disenrolling PMP service locations as directed by the CMO(s) or as needed due to changes in the PMP enrollment. (Mandatory changes; for example: PMP no longer licensed, deceased) Continue generating notices to PMPs for disenrollment/reenrollment status changes. Existing w/minor modifications. Yes Generate notices to CMO(s) for disenrollments as result of the following reasons PA: Voluntary Disenroll PB: Provider Medicaid Eligibility Terminated PC: Group Medicaid Eligibility Terminated PD: PMP Specialty Changed to NonManaged Care PE: PMP Service Location No Longer Active PF: PMP Group Enrollment Terminated PG: Mandatory Disenrollment PT: PMP moves from group to individual location PU: PMP moves from individual to different individual PR: PMP moves from individual to group location PV: PMP moves from group to different group location PN: PMP moves to another MCE Acceptance Criteria: EDS will quality review the received CMO disenrollments and perform the update as applicable. The PMP dis-enrollments will be reviewed as completed by the end dates reflected in the IndianaAIM. The PMPs will not be viewable in Web InterChange-Provider Profile and Provider Search. Will verify that dis-enrollment of PMP occurs by PMP. EDS will ensure that the correct letter is generated based on the testing scenarios developed for the Web enrollment. Source: Fiscal agent to report the following PMP enrollment and disenrollment statistics PMP Panel full, hold, stop percentages PMP to member ratio YES Will there be any other reporting due to multiple CMOs? NO these reports are created by program, (RBMC, MS, CS) Acceptance Criteria: Quality review will be performed by EDS to ensure accurate reporting. 3.10.The CMO specialists and ancillary providers will be identified as part of CS program through the CMO Ancillary Provider file process. This will be done by CMO. EDS will perform the auditing process to ensure validity of provider information based on the data listed in IndianaAIM and generate error reports to the CMO for providers that failed the auditing process. EDS will load the accepted specialists and ancillary providers to the applicable CMO on the ancillary provider table which will enable the providers to be viewable in the IndianaAIM ancillary provider window.. Acceptance Criteria: Source: H3 requirements were reviewed on 3/9/07. See HLR for other sources. The system must be able to process claims for the Care Select program. Accept and adjudicate compliant claim transactions (for all applicable claim types) and NCPDP (pharmacy) claim transactions for the Care Management program. This includes web, paper and EDI. Yes, work as it does today with MedSelect. PBM receive data from EDS, identify Restricted Card information to CMO. CMO does the management of R.C. Claims should be stamped as CS and with the CS CMO based on the From dates of service based on header for claims such as inpatient and detail for claims such as medical, home health and outpatient. Pharmacy Compound Medical Dental Inpatient Outpatient Home Health and Hospice non-institutionalized (no LOC on file) Nursing Home-Members enrolled in an NF LOC will not be part of the 7/1/07 implementation and must bypass all CMO editing. Crossovers . Will work the same as Medicaid Select and bypass need for CS PMP authorization. Acceptance Criteria: 1) Show a claim for each claim type and ensure each claim processed and stamped as CS. 2) Run query to identify test claims show as CS for CS members only. 3) Validate system shows correct MC program for member moving between MC programs or from FFS. A window within claims inquiry must display the CS affiliation and the CS CMO assigned on the date of service Acceptance Criteria: Identify through claims windows that it is a CS claim and CS CMO Will be used in reporting (H7 identifies all reporting requirements) Acceptance Criteria: See H7 for report testing. Source: All waiver functionality will remain the same for waiver services. No CS PMP referral and certification required when the following criteria is met: Waiver recipient Waiver provider specialty Waiver service Acceptance Criteria: Show individual HCBS waiver processed claim to show no CS impact. Waiver member for non-waiver services will be considered under the CS program CS Waiver member for non-waiver services billed by the members CS PMP do not require referral. Acceptance Criteria: Show claim for a CS member with waiver level of care and a non-waiver service billed by the members CS PMP to ensure the claim bypasses the edits for PMP authorization. CS Waiver member for non-waiver services billed by a provider other than the members CS PMP require referral and certification codes, unless service is considered self referral. Acceptance Criteria: 1) Show claim for a CS member with waiver level of care and a non-waiver service that is considered a CS Self Referral category, which is billed by a provider other than the members CS PMP to validate that it will bypass CS PMP need for authorization. 2) Show a claim for a CS member with waiver level of care and a non-waiver service that is not considered a CS Self Referral category, which is billed by a provider other than the members CS PMP, to validate that it will edit the claim for CS PMP authorization (provider number and 2-digit certification code). Source: Hospice claims, which are not institutionalized, should be considered as Care Select. Claims will be identified as CS. Claims will not require PMP or referral/certification code. All other hospice remain intact. Acceptance Criteria: 1) Show claims for Hospice members who do not have a Level of Care on file which are billed for hospice services will be stamped as CS but not edit for CS PMP referral. 2) Show claim for Hospice member that is enrolled in Hospice but has a LOC on file, that bypasses all CS editing and is not stamped CS. Source: Care coordination service (HCPCS code) will only be billable by a CS PMP or Nurse Practitioner. No other known covered services changes for this program. Need to identify these codes, not using geriatric codes Create edit to limit care coordination service to CS PMP or Nurse Practitioner. Claims for NPs are identified by provider specialties 090 Pediatric NP, 091 Obstetrical NP, 092 Family NP, and 093 Other NP. In addition, for NPs are identified by modifier SA Nurse Practitioner. Provider specialties 090 093 will reduce the allowed to 75% of the IHCP rate. Services appended with modifier SA will calculate the allowed amount at 100% of the IHCP rate. Acceptance Criteria: 1) Show claim billed by a NP enrolled with provider specialty 090, 091, 092 or 093, for the new PIC, and that does not deny for invalid service to provider. 2) Show claim billed by a provider specialty other than a NP specialty, for the new PIC, that denies for the appropriate edit invalid service to provider. 3) Show claim billed by the CS members CS PMP, for the new PIC, that does not deny for invalid service to provider. 4) Show claim billed by a CS PMP other than the assigned CS PMP, but that is in the same group as the assigned CS PMP, that is billed with a NP modifier that denies for the audit. Source: Care coordination services limited to 2 times per year in a 12 mos period (rolling year). Same provider Same procedure (PIC) Report to identify how many times member switched PMPs for billing the coordination code (PIC) (BO or report). No attachment needed. Acceptance Criteria: 1) Show claim billed for CS member by the CS PMP that has not exceeded the limit and allows the service. 2) Show claim billed by the CS PMP that exceeds the 2 per 12 month rolling period that denies for audit for same CS provider. 3) Show claim for a CS member that has exceeded the 2 per 12 month rolling period for CS PMP A, which billed by CS PMP B that bypassed the audit for the CS PMP B as it is the first of 2 allowed billed by the CS PMP B. Source: Nurse Practitioners - Need to make sure the N.P is associated with the CMO and be able to identify in the system. Assumption: All NPs must be enrolled with an individual number to be identified with the CMO as well for audit purposes. (if not enrolled, modifiers will need to be the identifier) . The system will not associated a NP with the CMO on 7/1/07. This functionality will be scheduled for a future modification. Acceptance Criteria: 1) Show claim billed for CS member by a NP (prov speciality 090 093) who is part of the group the CS members PMP is assigned and the claim allows the service. 2) Show claim billed by a NP (prov spec 090 093) that is not part of the CS PMPs group that denies the service. 3) Show claim billed by the CS members CS PMP with a nurse practitioner modifier appended to the care coordination service, which allows the service. Source: The system must identify claims for CS members. This must emulate how it occurs for Medicaid Select by new subprogram Source: The Care Select provider should receive an additional fee per member per month. The fee should be $15 per member per month. Question about partial per meeting on 3/3/07. No partial administration fees will be paid for the 7/1/07 implementation. Acceptance Criteria: Show a CS PMP who has been assigned a CS Member in a month and that a $15.00 administration fee is paid to that CS PMP. Show the same CS PMP receives the $15.00 per month until the CS PMP assignment is terminated. The actual $15 fee will be paid using the same process it is today for MedSelect Acceptance Criteria: Show the report that displays the CS member and the associated $15.00 administration fee. (a separate report for each CMO).. The fee to the CS PMP should end when the recipient is no longer eligible for the CS program or moved out of the providers panel. Retroactive eligibility should not be considered in the automated process. Acceptance Criteria: Show the report that is generated after the CS member has been terminated from the CS program to demonstrate the $15.00 no longer appears on the report. A manual process for additional months and recoupment of the admin fee needs to be created on a case by case basis as directed by the State. Same as MS and HH. Acceptance Criteria: Show a manually entered $15.00 admin fee paid to a CS PMP before a claim for a CS member has been entered into the IndianaAIM system. The CS PMP who is assigned when the job runs will be the PMP who receives payment for multiple PMP assignments valid between administration payment cycles. Source: Per meeting on 3/15/07 Acceptance Criteria: Show a CS member that has been assigned to more than one CS PMP within the same month, and demonstrate the $15.00 administration fee is paid to the CS PMP effective when the job runs and not to the other CS PMPs assigned in the same month. (Per 3/15/07, meeting). Enable the administration fee to be discontinued for a PMP by member with an active PMP assignment as directed by the CMO Source: Per meeting on 3/15/07 Acceptance Criteria: Enter an end date on administration fee for a PMP by member and demonstrate the $15.00 administration fee is not paid to the PMP. (Per 3/15/07, meeting). Develop a mechanism for the CMO(s) that will provide a look back at the CS PMP-member claim history to assist with identifying the CS PMPs who are not providing care and may require a stop payment of the administration fee. Source: Per meeting on 3/15/07 Acceptance Criteria: Create claim history for PMPs by member and demonstrate on the report the last claim presented for the member. (Per 3/15/07, meeting). The CMOs will have access to business objects, IndianaAIM, Web interChange and OnDemand reporting for researching and inquiring on members and their claim history. (Per 5/11/07, state meeting) Continue generation of HIPAA-compliant 835 remittance advice (RA) transactions. Proprietary RAs will continue generating in accordance with HIPAA and IHCP business practices. Acceptance Criteria: Show Remittance Advice Statements that display claims for CS members. Show how the total Administration Fee monthly amount for the CS PMP is displayed on the statement. (Same as MS) Some services remain self-referral (e.g., chiropractic, podiatry, behavioral health, family planning, dental, vision, IEP, ER as required by IC. The new edit must use the same procedure and diagnosis groups as edit 1044. Procedure groups are 152 and 153, diagnosis groups are 41, 42, and 43. The following will not require PMP referral: Chiropractic Podiatry Vision Dental Mental Health Individual Education Plan (IEP) School Corp Specialty 120 CSHCS- Specialty 212 MRT/PASSR/First Steps Radiology, Lab, Anesthesiology and Transportation Family Planning (DX) ER refers to emergency services that must bypass the need for CS PMP authorization. This is based on the following: An emergency diagnosis is on the claim (see System Code Table/Diagnosis Type 21/Group 21) and/or; An emergency indicator on the claim Acceptance Criteria: 1) Show claim for a CS member, for type of self referral each service, billed by a provider other than the CS PMP, that bypasses the need for CS PMP authorization. 2) Show a claim for a CS member, for a service other than a CS self referral service, that normally requires CS PMP authorization, but the claim is coded as an emergency that bypasses the need for CS PMP authorization. Show claim for a CS member that is billed on the ADA claim form that bypass the need for CS PMP authorization. Show a claim for CS member billed by a mental health provider that bypasses the need for CS PMP authorization. Show a claim for CS member billed by a MRO provider that bypasses the need for CS PMP authorization. Show a claim for a CS member billed for mental health service, but the provider is other than a mental health or MRO type/specialty that does not bypass the need for CS PMP authorization. Show claim for a CS member, billed by a school corporation (120) that bypasses the need for CS PMP authorization. Source: Modify the system to ensure that claims received for the care select program require the certification code as appropriate. Modify the certification code edits to ensure that the necessary edits are active for the care select program. Services rendered by out of state CS PMP will not require referral, certification code or prior authorize. Acceptance Criteria: Show a claim for a CS member that has a CS PMP with out of state enrollment designation that does not edit for prior authorization or CS PMP authorization. Copayments such as transportation, pharmacy and emergency room will mirror Medicaid Select Source: Care Select Summary of decisions.doc, CM detailed 8_16_06.doc identified by OMPP CS workgroup Acceptance Criteria: Show claim for CS member billed for a service that requires a state mandated copayment that deducts the correct amount. Suspended claims will be worked by CM vendor assigned to the member on the date of service Med. Policy, Medical review and lockin audits will go to the CMO vendor assigned to the member on the date of service. If the member switches to a new CMO before the claim is adjudicated, the CMO that was originally assigned the claim must continue to work the claim) Create new claim location for each CMO for medical policy, medical review and lockin Claim locations 22, 23 and 31 will be assigned to the FFS CMO and remain on the edits. The new claim locations will crosswalk to the 22,23 and 31 and will display in the claim location window. Location 22,23, and 31, as well as the crosswalk claim locations for the CS CMOs, will remain as a non-interest location. 4.11.2.1 New Unique CMO User IDs must be identified in Claims Scheduler that will be sent to each CMOs assigned claim locations. 4.11.2.2 Expand the total claim suspense volume per user, per edit from 500 to 1000 4.11.2.3 Create report that identifies the total inventory of claims in suspense per CMO, per user, per claim type, per claim location Transition plan will need to be created for items currently in Medical Policy and RCP claim locations Acceptance Criteria: Show claims that hit audits and suspend to CMO for which the CS member is assigned on the from date of service, and how it appears in appropriate CMO scheduler and assigned proper UserID. Show a user ID that allows up to 1000 per edit in scheduler. Source: Claims for providers on Pre-Payment Review will continue to suspend to SUR (location 30) Acceptance Criteria: Show claims for providers on Pre-pay review that suspend to location 30 to the assigned CMOs scheduler and UserID. CM vendors will monitor utilization. Business Objects must report services by CMO subprogram, and CMO assigned at the time the BO report is generated. These reports will be used by CM vendor to monitor utilization (H7 identifies all reporting requirements) Acceptance Criteria: Show BO reports that identify CS services provided to CS members. Source: H4 requirements were reviewed on 3/8/07. See HLR for other sources. Each CMO must have view capability only for all Restricted Card windows and reporting tools. The Enrollment Broker is responsible for entering new Restricted Card information and perform updates to member lockin criteria and must have access to all member lockin windows and reporting tools. Modify the Recipient lockin letter windows to display the CMO for which the member was assigned at the time the letter was generated. Modify the Recipient lockin letter windows to allow the user to sort by CMO Acceptance Criteria: Show Recipient Lockin letter windows and the CMO identifier and the sort capability. Source:. Modify the system for Prior Authorization processing for both FFS, Medicaid Select and Care Select members provided by the Care Select vendor. Modify the system for Care Select to require prior authorization for services that require prior authorization for the Traditional Medicaid program. Source: RFS-7-62 Acceptance Criteria: Show claim for CS member for a service that requires prior authorization in Traditional Medicaid (such as hysterectomy) , that edits for prior authorization when the CS PMP information is on the claim. Modify the system to ensure that Prior Authorization for services assigned to their respective CMO will follow current PA guidelines and established operating procedures, beginning 10/1/07 to include PA submitted via Web interchange and the 278 transaction. Current PA contractor will be responsible for new requests and system updates through 12/31/07. Modify the Search for requests window when a provider initiates a web PA or 278 transaction is received to be utilized as a work scheduler for each CMO. Establish security for this window to ensure each CMO organization will only view new prior authorization requests for members that are identified as a member within their CMO organization. Modify the Prior Authorization window to inform the PA analyst the member is not part of their CMO organization when a new PA request is received. Create a warning message that will be displayed to the PA analyst. Create a business process for PA requests received via paper or fax to allow the PA analyst to reject the PA request received when the member is not part of the CMO that received the PA request. Modify the prior authorization windows to not allow a user to modify a PA that has been created and saved but is in a reject status. Create new verbiage to be used when a PA is received and placed in a rejected status that will be generated on the PA decision letter Modify the 278 transaction to reject a PA request when the PA request received is not the members current CMO. Modify the 278 transaction response to display the members current CMO. Modify the PA Web submission to accept more than one CMO name. Create a process for PAs submitted via the web that will verify the members current CMO and place and store the members CMO in the appropriate field in the transaction. Modify the Prior Authorization number to identify the CMO that created the PA request. Modify the current PA numbering scheme to allow the user ID to be alphanumeric. Provide the ability to store unique user IDs for each CMO/FFS. Create a table that will store the range of user IDs that are assigned to each CMO/FFS. Provide the ability for a user to add or update a range of user IDs for a specific CMO/FFS. Create a new edit that will ensure the PA number is unique. Ensure that the CMO uses their range of the two-digit user ID when they enter a new PA number/request. Modify the PA on-line print job to display the members CMO address that performed the updates for PA. Modify the Web interchange PA Inquiry window to accept an alpha numeric PA number. Provide the ability for a user to enter an alpha numeric PA number in the PA# field. Modify the Attachments help info to display the appropriate CMO information. Provide the ability for multiple transition dates to occur for a CMO/FFS vendor Create a table that will provide the flexibility for a CMO/FFS vendor to have a different start date outside of the 10/1/2007 implementation date. Ensure that the table created will provide flexibility to support a defunct CMO. Source: RFS-7-62 Acceptance Criteria: Show list of assigned user IDs for each CMO. If user is part of the FFS CMO and CS CMO which are under the same entity, they must have separate user IDs. Show a PA for each CMO vender that displays the appropriate PA Analyst User ID. Test the submission of a 278 transaction, web submission to ensure that the worklist is created correctly. Test the rejection of a PA request, and create the PA decision letter to ensure the correct verbiage is displayed to the provider/member. Create a business process for PA requests which need to be updated and were created by HCE or other CMO/FFS vendor pre or post the 10/1/2007 implementation. Ensure that each CMO/FFS vendor can perform a system update to a PA. Provide the ability to determine which CMO/FFS vendor performed the system update to a PA request. Ensure CM vendors are aware of procedure crosswalk as relates to PA. Source: RFS-7-62 Acceptance Criteria: <(Need to see HCE transition plan ) Modify PA letters to display the correct CMO/FFS address. Modify the PA decision letter to display the appropriate CMO/FFS address. Create a new window that will store specific addresses within a specific CMO/FFS organization. Provide the ability to select a letter/form/report to be created and added and deleted to a specific address within a CMO/FFS organization. Provide the ability to store multiple phone numbers for each FFS/CMO vendor. Modify the Hearing and Appeals letter that is generated with the PA decision letter to display the appropriate CMO/FFS address and the FSSA/OMPP address. Create additional verbiage in the administrative review section that will direct the provider/member to appeal to the CMO that denied the request or submit a new PA request to the members current CMO. Provide the ability to store the states address and generated on the necessary PA letters. Modify the PA decision pre-printed envelopes to display the correct CMO address. Modify PA Reports to report data for each CMO/FFS vendor. Create an indicator at the end of each report generated that will identify the CMO/FFS/or default (HCE) vendor report and summary report. PAU-0002-D PAU-0005-M PAU-0105-M PAU-0017-M PA reports will generate data for the current day/month/quarter based on the CMO/FFS vendor that created/updated the PA request. Allow only the CMO/FFS/HCE vendor to view their specific report in On-Demand. Allow the OMPP staff to have super user capability to view any reports generated in On-Demand. Modify report PAU-0002-D-Prior Authorization 7-10 days old report. Modify the report name to display PA 4 days old report Modify the summary page of the report to display PA requests that are equal to or greater than 4 days. Source: RFS-7-62 Acceptance Criteria: Show sample reports that display member data specific to the CMO at the time the report was generated. Modify the PA window to display the Current CMO for which the member is assigned at the time of the PA inquiry. Security parameters must be defined for both the inquiry and update capability Display the CMO name. Display CS in the subprogram name when the member is identified as Care Select. An additional window may need to be created that displays the history of updates as performed by the various user IDs. Source: RFS-7-62 Acceptance Criteria: Show PA window that contains PA information for an active CS member. PA for members that are identified as Care Select but are in a waiver program will continue to work per current design. Roeing (Insite) will continue this function. Source: RFS-7-62 Acceptance Criteria: Receipt and process of Waiver PA file. PA for members that are in the First Steps program will work per current design. Source: RFS-7-62 Acceptance Criteria: First Steps PA PA for Pharmacy services will continue to be processed by PBM Contractor. Source: RFS-7-62 Acceptance Criteria: Show PA for pharmacy service entered by PBM contractor. Create a system process that will purge prior authorization history when the PA is equal to or greater than seven years. Purge the PA if the end date of the PA in the file is equal to or greater then seven years. Ensure that PA requests for lifetime procedures will be maintained. Source: RFS-7-62 Acceptance Criteria: Verify that the PA history is not displayed in the PA history windows if the PA end date is equal to or greater than 7 years old. The system must be modified to enroll Care Management Organization(s) (CMOs) Establish CMO demographic information CMO name CMO address CMO contact name CMO email address CMO provider services phone number CMO member services phone number Affiliate IHCP providers as CMO-network providers Source: 3/1/07 meeting Acceptance Criteria: CMO information will translate to PMP service locations and assignment history (CMO ID) and the eligibility verification systems (CMO demographic information). Establish secure data connections and exchanges between EDS systems and the CMOs AIM Restrict managed care member assignment functions to the appropriate CMO Restrict CMO member-specific prior authorizations to the appropriate CMO Determine and restrict AIM access to the CMO vendor responsible for FFS prior authorizations WCreate new Web administration functionality to establish security profiles for the CMOs to access the various functions in Web InterChange. eb interChange Claims inquiry No access will be provided for the CMOs via web for claim inquiry. Provider Enrollment Limit Care Select PMP enrollment and update activity performed by the CMOs to providers contracted with their plans Member inquiry Limit Care Select inquiry based on PMP information provided. File exchange CMOs should only access their files and not files of other CMOs or MCOs Business Objects CMOs should only access business objects universes specific to their contracted functionality: CMOs as Care Select organizations CMOs as their plans PA vendor CMOs as the master PA vendor On-Demand CMOs should only access On-Demand reports specific to their plan and/or contracted functionality: CMOs as Care Select organizations CMOs as their plans PA vendor CMOs as the master PA vendor Source: 3/27/07 meeting Acceptance Criteria: CMO-specific information will be viewable to that plan and not shared among plans as directed by OMPP. H7 The system must be modified for reporting of the Care Select program. Support CM vendor with system reports, reporting tools, extracts and queries. Mental health claims must be reportable to the CMOs. Mental health services incurred by Care Select members, including MRO, will be overseen by the members respective CMOs. All claims will continue to be paid by EDS. Source: H7 requirements were reviewed on 3/2/07 Acceptance Criteria: Mental health claims data will be available in Business Objects for CMO-designed mental health research. Provide established data extracts to the CMOs: CDMS data extract Enrollment Broker PMP extract Note: no longer required for CMOs per decision that Enrollment Broker will outreach to eligibles. Medstat data extract(s) for Milliman Provider data (Medstat) extract for MCOs NPI provider crosswalk PMP Assignments. See 834 requirements under H2. Source: H7 requirements were reviewed on 3/2/07; 5/10/07 project status meeting Acceptance Criteria: Extracts will be generated for the CMO Update all current reports, that are relevant, to reflect the CM status. 7.2.1 OnDemand 7.2.1.1 MGD-0001-M Primary Medical Provider Listing 7.2.1.2 MGD-0003-M Administrative Payment Listing 7.2.1.3 MGD-0005-BM PCCM PMP Enrollment Roster 7.2.1.4 MGD-0014-D Certification Code 7.2.1.5 MGD-0014-Q Certification Code Summary 7.2.1.6 MGD-0015-Q Certification Error Report 7.2.1.7 MGD-6801-D Member AFI Exception Report 7.2.1.8 MGD-6802-D Member AFI Update Report 7.2.1.9 MGD-0016-D Hoosier Healthwise Recipient Linkage 7.2.2 Update system-generated letters for Care Select. See requirements for letters under H3. 7.2.2.1 PMP certification code letters to PMPs 7.2.2.2 PMP disenrollment letters to PMPs and CMOs 7.2.2.3 PMP disenrollment/reenrollment letters to PMPs and CMOs 7.2.3 Incorporate Care Select program data in system extracts: 7.2.3.1 CDMS data extract 7.2.3.2 Enrollment Broker PMP extract 7.2.3.3 Medstat data extract(s) for Milliman 7.2.3.4 Provider data (Medstat) extract for MCOs 7.2.3.5 NPI provider extract 7.2.4 Incorporate Care Select program data in ad-hoc reports 7.2.5 Incorporate Care Select program data in MSIS data tapes 7.2.6 Incorporate Care Select program data in MAR 7.2.6.1 1915b waiver report 7.2.6.2 MAR-5844-Q 7.2.6.3 MAR-5845-Q 7.2.7 Incorporate Care Select program data in the CMS64 7.2.7.1 Allocation to be determined as Milliman develops the waiver renewal cost effectiveness demonstration. 7.2.8 Incorporate Care Select in MEG expenditure reporting Source: H7 requirements were reviewed on 3/2/07. OMPP email response from Ginger Brophy 5/9/07 and 7/18/07. Acceptance Criteria: Extracts and reports will generate for other entities aside from the CMOs with appropriate data such as subprogram designation and CMO IDs. Ensure Additional Function Indicator (AFI) communication occurs between CMO vendors/EDS/State. CMOs to provide AFI data applicable to their members. (Enrollment broker has batch and/or AIM window update capability) Support batch entry of CMO member-specific AFI Support AIM window entry of CMO member-specific AFI Generate a return file of AFI information to CMOs, when applicable, for members actively assigned to their plans. File will contain CMO self-reported AFI data File will also contain system-generated AFI data such as WARD (ward indicator), LOCK (restricted card), PREG (pregnancy aid category) Source: H7 requirements were reviewed on 3/2/07; internal review for multiple CMOs Acceptance Criteria: The CMO will be able to access claims data using Business Objects for SMI tracking purposes, and for other data gathering activities including AFI. Provide business objects to the CMOs. This will include training to the vendors for the application. Provide up to 2 Business Objects licenses per CMO Provide 4 per CMOs if 3 are selected. Source: Donna Wells 8/21/07 meeting Train licensed users to the tool: what and how its used, how to export reports Customize Business Objects universes to be specific to CMOs secure data, data used by the CMOs as PA vendor, and other data as directed by OMPP Source: H7 requirements were reviewed on 3/2/07; internal review for multiple CMOs Acceptance Criteria: The CMO will be able to access claims data using Business Objects for SMI tracking purposes, and for other data gathering activities including AFI. Provide On-Demand access to the CMOs for reports specific to their plans and/or Prior Authorization involvement. Determine the CMO users Establish connectivity Train new users to the tool: what and how its used Provide secure access to necessary Care Select reports as determined by OMPP Provide secure access to necessary reports for Prior Authorization (PA) Provide secure access to claims images as a function of being the PA vendor Source: H7 requirements were reviewed on 3/2/07; internal review for multiple CMOs Acceptance Criteria: On-Demand reports will be tested to verify integration of CS data, plus EDS will confirm limited On-Demand access by the CMO. Create new reports relevant to the CM program not already referenced in other requirements Create a CMO member listing for FSSAs use in validating CMO invoicing Create a Care Select eligible versus CMO enrolled report for OMPPs use in monitoring assignment activity Source: H7 requirements were reviewed on 3/2/07 Acceptance Criteria: New reports will be tested and reviewed with OMPP. H8 Automate the infrastructure of the CDMS system. NOTE: All of the code lists within requirement #8 that show an expanded list of a wildcard character (i.e. diagnosis code 250*) are valid as of 4/17/2007. These lists may change due to FSSA or CMS instruction. Data for the states Chronic Disease Management System must include Care Select data in the extracts. Data files include the following: Quarterly data refresh files Member selection data Member risk stratification data PMP data file for high risk members Address files for both high and low risk members Daily member data file Weekly claims data file Monthly rendering provider file Monthly billing provider file Monthly Milliman provider address file Monthly Milliman provider managed care file Monthly Milliman provider group file 8.1.1. Incorporate the Care Select subprogram into the initial data selection of the Disease Management members. Automate the manual processes that exists today for opt-out, selection, rendering provider information, and stratification for all disease states other than Asthma. 8.2.1. Create an automated process to accept an Opt-out member file from CDMS and update the IndianaAIM Disease Management segments with the appropriate end date. 8.2.1.1 Opt-out file optout.dat.mmddyyyy from CDMS must be in the following format: RID, Name, OptOutCode, OptOutReason, OptOutDate and Risk Factor (optional) 8.2.1.2 Opt-out reason codes are as follows: 20 Unsubstantiated Diagnosis 21 Member Refuses Participation 22 Member Incarcerated 88 Other-Supervisor Approved 8.2.1.3 The process will be as follows: If member is not deceased, update the current end date to the run date plus a year. Members who have opted out within the last six months are excluded 8.2.2. The automated selection process includes identification of Indiana Chronic Disease Management Program (ICDMP) members for the following IndianaAIM disease states: Diabetes (DM), Congestive Heart Failure (CHF), Hypertension (HTN), and Cardiovascular disease (CVD). The process begins by selecting all available members, then the initial exclusions are run. Finally, the remaining potential members are run through the various queries. All of these steps are outlined below. 8.2.2.1 Initial Selection All currently Medicaid eligible members who are 18 years of age or older. 8.2.2.2 Exclusion Criteria: Member is deceased Member not currently eligible for Medicaid Member is in Risk Based Managed Care (RBMC) Member has dual eligibility with Medicare and Medicaid Member is in the 590 program, which is a State-funded program for members in State-run psychiatric facilities Member is in the ARCH program, which is a State-funded program for Aged Residents in County Homes Member is spend-down Member has a Level of Care (Nursing home members, waiver members) Member has had a LTC claim for the selection period Member has End Stage Renal Disease (ESRD) ESRD detail procedure codes (run against both physician and UB92 claims): PRocedure CodeSak procedureProcedure Description1125890918END STAGE RENAL DISEASE R1125990919END STAGE RENAL DISEASE R1126090920END STAGE RENAL DISEASE R1126190921END STAGE RENAL DISEASE R1126290922END STAGE RENAL DISEASE R1126390935HEMODIALYSIS PROCEDURE WI1126490937HEMODIALYSIS, REPEATED EV1126990945DIALYSIS PROCEDURE OTHER1127090947DIALYSIS, REPEATED EVAL1129290989DIALYSIS TRAINING, COMPLE1129690993DIALYSIS TRAINING, INCOMP1130290999UNLISTED DIALYSIS PROCEDU1306290923ESRD RELATED SERVICES, DA1306390924ESRD RELATED SERVICES, DA1306490925ESRD RELATED SERVICES, DA ESRD diagnosis codes (run against both physician and UB92 claims): Diagnosis CodeDiagnosis DescriptionV560ADMIT FOR RENAL DIALYSISV561FIT AND ADJUST DIALYSISV562FITTING AND ADJUSTMENT OF585CHRONIC RENAL FAILURE586RENAL FAILURE NOS Member has had a heart and/or lung, liver, pancreas, bone marrow or kidney transplant. Transplant detail procedure codes (run against both physician and UB92 claims): PRocedure CodeSak procedureProcedure Description618033935HEART-LUNG TRANSPLANT WIT618233945HEART TRANSPLANT, WITH OR651538240BONE MARROW TRANSPLANTATI651638241BONE MARROW TRANSPLANTATI712447135LIVER TRANSPLANT, WITH OR729750360TRANSPLANTATION OF KIDNEY730150380RENAL AUTOTRANSPLANTATION1209648554TRANSPLANTATION OF PANCRE1209748556REMOVAL/PANCREATIC ALLOG1229647136TRANSPLANT/LIVER Transplant diagnosis codes (run against both physician and UB92 claims): Diagnosis CodeDiagnosis DescriptionV420KIDNEY TRANSPLANT STATUSV421HEART TRANSPLANT STATUSV426LUNG TRANSPLANT STATUSV427LIVER TRANSPLANT STATUSV4281ORGAN OR TISSUE REPLACEDV4283ORGAN OR TISSUE REPLACEDV432HEART REPLACEMENT NEC Transplant UB92 header procedure codes PRocedure CodeSak procedureProcedure Description33504081LUNG TRANSPLANTATION33514082UNILATERAL LUNG TRANSPLAN33524083BILAT LUNG TRANPLANTATION335 989LUNG TRANSPLANT375 1145HEART TRANSPLANTATION50591706LIVER TRANSPLANT NEC52801790PANCREAT TRANSPLANT NOS52811791REIMPLANT PANCREATIC TIS52821792PANCREATIC HOMOTRANSPLAN52831793PANCREATIC HETEROTRANSPL55691903KIDNEY TRANSPLANT NEC Transplant UB92 DRG Codes: DRG CodeSak DRGDRG Description010391HEART TRANSPLANT0302285KIDNEY TRANSPLANT0480446LIVER TRANSPLANT0481447BONE MARROW TRANSPLANT0795627LUNG TRANSPLANT 8.2.2.3 Diabetes Selection Criteria search includes members over the age of 18 who had the following criteria: Search all UB92 and physician claims for a diagnosis code of 250* any diagnosis code (diagnosis code 1 through 4) where * is any numeric. Diagnosis CodeDiagnosis Description250  DIABETES MELLITUS2500  DIABETES MELLITUS UNCOMP25000  DM NO COMP, T2, CONTR25001  DM NO COMP, T1 CONTR25002  DM NO COMP, T2, UNCON25003  DM NO COMP, T1, UNCON2501  DIABETES W KETOACIDOSIS25010  DM W/ KETO, T2 CONTR25011  DM W/KETO, T1, CONTR25012  DM W/ KETO, T2 UNCONTR25013  DM W/ KETO, T1, UNCONTR2502  DIAB W HYPEROSMOLAR COMA25020  DIAB HYPEROSM T2 CONTR25021  DM HYPEROSM, T1, CONTR25022  DM HYPEROSM, T2 UNCON25023  DM HYPEROSM T1 UNCONT2503  DIABETES WITH COMA NEC25030  DM OTH COMA T2 CONTR25031  DM OTH COMA T1 CONTR25032  DM OTH COMA T2 UNCONTR25033  DM OTH COMA T1 UNCONTR2504  DIAB W RENAL MANIFEST25040  DM RENAL MAN T2 CONTR25041  DM RENAL MAN T1 CONTR25042  DM REN MAN T2 UNCONTR25043  DM REN MAN T1 UNCONTR2505  DIAB W OPHTHALMIC MANIF25050  DIABETES WITH OPHTHALMIC25051  DM OPHTH MAN T1 CONTR25052  DM OPH MAN T2 UNCONTR25053  DM OPH MAN T1 UNCONTR2506  DIAB W NEUROLOGIC MANIF25060  DM NEURO MAN T2 CONTR25061  DM NEURO MAN T1 CONTR25062  DM NEUR MAN T2 UNCONTR25063  DM NEUR MAN T1 UNCONTR2507  DIABETES W CIRCULAT DIS25070  DM CIR DISORD T2 CONTR25071  DM PERI DISORD T1 CONTR25072  DM PERI DISO T2 UNCONTR25073  DM PERI DISORD T1 CONTR2508  DIABETES W MANIFEST NEC25080  DM OTH MAN T2 CONTR25081  DM OTH MAN T1 CONTR25082  DM OTH MAN T2 UNCONTR25083  DM OTH MAN T1 UNCONTR2509  DIABETES W COMPLIC NOS25090  DM COMPL T2 UNCONTR25091  DM COMPL T1 CONTR25092  DM COMPL T2 UNCONTR25093  DM COMPL T1 UNCONTR Specific Therapeutic Class (part of pharmaceutical smart key) found by using (substr(cde_smart_key,3,4) Specific TheraPEUTIC CLASSSTC Description'0177'INSULINS'0178'HYPOGLYCEMICS, INSULIN-RELEASE STIMULANT TYPE'0179'HYPOGLYCEMICS, BIGUANIDE TYPE (NON-SULFONYLUREAS)'0576'DIABETIC SUPPLIES'4995'URINE GLUCOSE/ACETONE TEST AIDS,STRIPS'7328'DIABETIC ULCER PREPARATIONS,TOPICAL'7768'HYPOGLYCEMICS, ALPHA-GLUCOSIDASE INHIB TYPE (N-S)'7769'HYPOGLYCEMICS, INSULIN-RESPONSE ENHANCER (N-S)'7770'HYPOGLYCEMICS, ABSORPTION MODIFIER, UNSPECIFIED'7771'HYPOGLYCEMICS, UNSPECIFIED MECHANISM'7775'HYPOGLYCEMICS, COMBINATION 8.2.2.4 Congestive Heart Failure Selection Criteria search includes members over the age of 18 who had the following criteria: When running the CHF criteria, it is looked at two ways. The first is CHF plus Diabetes and the second is CHF only. When searching for diagnosis codes the search includes any diagnosis code (diagnosis code 1 through 4) where * is any numeric. CHF diagnosis codes in general are defined as: 402*1, 404*1, 404*3, 428* or 39891. These are defined in a table below. 8.2.2.4.1 CHF plus Diabetes - search all UB92 and physician claims first for the CHF diagnosis codes (listed below). Then within that result set look for claims that also meet the criteria for Diabetes diagnosis codes. 8.2.2.4.2 CHF Only - search all UB92 and physician claims first for the CHF diagnosis codes (listed below). Then within that result set remove any claims that also meet the criteria for Diabetes diagnosis codes. Diagnosis CodeDiagnosis Description39891  RHEUMATIC HEART FAILURE40201  MAL HYPERT HRT DIS W /HF40211  BENIGN HYP HRT DIS W/HF40291  HYPERTEN HEART DIS W/HF40401  HYP HRT & CHRON KID DIS M40403  HYP HRT & CHRON KID DIS M40411  HYP HRT & CHRON KID DIS B40413  HYP HRT & CHRON KID DIS B40491  HYP HRT & CHRON KID DIS U40493  HYP HRT & CHRON KID DIS U428  HEART FAILURE4280  CONGEST. HEART FAIL, NOS4281  LEFT HEART FAILURE4289  HEART FAILURE NOS42820  SYSTOL. HEART FAILURE NOS42821  ACUTE SYSTOLIC HEART FAIL42822  CHRON SYSTOL HEART FAIL42823  ACUTE ON CHRON SYST HRT F42830  DIASTOLIC HEART FAIL NOS42831  ACUTE DIASTOL HEART FAILU42832  CHRON DIASTOL HEART FAIL42833  ACUTE ON DIAST HEART FAIL42840  SYST AND DIAST FAIL, NOS42841  ACUTE SYST AND DIAST FAIL42842  CHR SYSTOL-DIAST HRT FAIL42843  ACUTE ON SYST-DIAST FAIL 8.2.2.5 Hypertension Selection Criteria search includes members over the age of 18 who had the following criteria: Hypertension (HTN) members are unique in that they must already have been found to have some form of Diabetes (either Diabetes only or CHF plus Diabetes), therefore, the beginning search group for HTN are the DM and CHF DM selected members. HTN diagnosis codes in general are defined as: 401* and 402*. These are defined below. Diagnosis CodeDiagnosis Description401  ESSENTIAL HYPERTENSION4010  MALIGNANT HYPERTENSION4011  BENIGN HYPERTENSION4019  HYPERTENSION NOS402  HYPERTENSIVE HEART DIS4020  MAL HYPERTENSIVE HRT DIS40200  MAL HYPERT HRT DIS W/O HF40201  MAL HYPERT HRT DIS W /HF4021  BENIGN HYPERTEN HRT DIS40210  BENIGN HYP HRT DIS W/O HF40211  BENIGN HYP HRT DIS W/HF4029  HYPERTENSIVE HRT DIS NOS40290  HYPERTEN HRT DIS W/O HF40291  HYPERTEN HEART DIS W/HF 8.2.2.6 Cardiovascular Selection Criteria search includes members over the age of 18 who had the following criteria: Cardiovascular (CVD) members are unique in that they must be run against both the members who have already been selected for other disease states AND the entire selection potential population. There are several criteria that make up the selection logic for CVD. This criteria includes the following which will be expanded upon below: Search through the past full four quarters claims for a list of procedure codes; Search through the past full four quarters claims for a specific list of diagnosis codes; Search through the past full eight quarters claims (2 years) for a specific list of different diagnosis codes; Search through the past full four quarters claims for the diagnosis code of Angina Pectoris (413.*) on at least two different dates of service; Search through the past full four quarters claims for the diagnosis code of Angina Pectoris (413.*) at least once AND at least one prescription from the attached list of drugs; Search through the past full four quarters claims for drug claims from the attached list of drugs on at least two different dates of service; Search through the past full four quarters claims for at least two drug claims containing at least two different medications from the attached list of drugs; Search through the past full four quarters claims for a list of DRG codes. Search through the past full four quarters claims for a list of procedure codes; PRocedure CodeSak procedureProcedure Description 33510  6060  CORONARY ARTERY BYPASS, A 33511  6061  CORONARY ARTERY BYPASS,AU 33512  6062  CORONARY ARTERY BYPASS,AU 33513  6063  CORONARY ARTERY BYPASS,AU 33514  6064  CORONARY ARTERY BYPASS,AU 33516  6065  CABG, VEIN, SIX OR MORE 33517  6066  CORONARY ARTERY BYPASS US 33518  6067  CORONARY ARTERY BYPASS VE 33519  6068  CORONARY ARTERY BYPASS VE 33521  6070  CORONARY ARTERY BYPASS VE 33522  6071  CORONARY ARTERY BYPASS VE 33523  6072  CABG, ART-VEIN, SIX OR MO 33530  6075  REOPERATION, CORONARY ART 33533  6076  CORONARY ARTERY BYPASS, A 33534  6077  CORONARY ARTERY BYPASS, A 33535  6078  CORONARY ARTERY BYPASS, A 33536  6079  CABG, ARTERIAL, FOUR OR M 35470  6283  TRANSLUMINAL ANGIOPLASTY, 35471  6284  TRANSLUMINAL ANGIOPLASTY, 35472  6285  TRANSLUMINAL ANGIOPLASTY, 35473  6286  TRANSLUMINAL ANGIOPLASTY, 35474  6287  TRANSLUMINAL ANGIOPLASTY, 35475  6288  TRANSLUMINAL ANGIOPLASTY, 75960  9295  TRANSCATH IV STENT RS&I 75962  9297  PERCUTANEOUS TRANSLUMINAL 75964  9299  PERCUTANEOUS TRANSLUMINAL 75966  9301  PERCUTANEOUS TRANSLUMINAL 75968  9303  PERCUTANEOUS TRANSLUMINAL 92982  11449  PERCUTANEOUS TRANSLUMINAL 92984  11450  EACH ADDITIONAL VESSEL 92995  11455  PERCUTANEOUS TRANSLUMINAL 92996  11456  PERCUTANEOUS TRANSLUMINAL 92980  12184  INSERT INTRACORONARY 92981  12185  INSERT,INTRACORONAR,STENT Search through the past full four quarters claims for a specific list of diagnosis codes; The general codes are: 411.*, 414.*, 429.2*, 429.7*, V45.81, V45.82, 433.0*, 433.1*, 434.*, 435.*, 362.34, 440.*, 445.*, 250.7 Diagnosis CodeDiagnosis DescriptionV4581  AORTOCORONARY BYPASS2507  DIABETES W CIRCULAT DIS36234  TRANSIENT ARTERIAL OCCLU411  OTH AC ISCHEMIC HRT DIS4110  POSTMYOCARDIAL INFARCT SY4111  INTERMED CORONARY SYND4118  AC ISCHEMIC HRT DIS NEC41181  ACUTE CORONARY OCC WO MYO41189  OTH AC ISCHEM HRT DIS NEC414  OTH CHR ISCHEMIC HRT DIS4140  CORONARY ATHEROSCLEROSIS4141  ANEURYSM OF HEART41410  ANEURYSM OF HEART41411  ANEURYSM CORONARY VESSELS41419  OTHER ANEURYSM OF HEART4148  CHR ISCHEMIC HRT DIS NEC4149  CHR ISCHEMIC HRT DIS NOS4292  ASCVD4297  SEQUELAE MYOCARD INFARC N42971  ACQUIR CARDIAL SEPTAL DEF42979  OTH SEQUELAE MYOCAD INFAR4330  BASILAR ARTERY OCCLUSION43300  OCCLUSION AND STENOSIS OF43301  OCCLUSION AND STENOSIS OF4331  CAROTID ARTERY OCCLUSION43310  OCCLUSION AND STENOSIS OF43311  OCCLUSION AND STENOSIS OF434  CEREBRAL ARTERY OCCLUS4340  CEREBRAL THROMBOSIS43400  CEREBRAL THROMBOSIS W/O M43401  CEREBRAL THROMBOSIS WITH4341  CEREBRAL EMBOLISM43410  CEREBRAL EMBOLISM W/O MEN43411  CEREBRAL EMBOLISM WITH CE4349  CEREBR ARTERY OCCLUS NOS43490  CEREBRAL ARTERY OCCLUSION43491  CEREBRAL ARTERY OCCLUSION435  TRANSIENT CEREB ISCHEMIA4350  BASILAR ARTERY SYNDROME4351  VERTEBRAL ARTERY SYNDROME4352  SUBCLAVIAN STEAL SYNDROME4358  TRANS CEREB ISCHEMIA NEC4359  TRANS CEREB ISCHEMIA NOS440  ATHEROSCLEROSIS4400  AORTIC ATHEROSCLEROSIS4401  RENAL ARTERY ATHEROSCLER4402  ATHEROSCLEROS-EXTREMITY44020  ATHEROSCLEROSIS44021  WITH INTERMITTENT CLAUDIC44022  WITH REST PAIN44023  ATHEROSCLEROSIS OF THE EX44024  ATHEROSCLEROSIS OF THE EX44029  OTHER ATHEROSCLEROSIS OF4408  ATHEROSCLEROSIS NEC4409  ATHEROSCLEROSIS NOS41400  CORONARY ATHEROSCLEROSIS41401  CORONARY ATHEROSCLEROSIS41402  CORONARY ATHEROSCLEROSIS41403  CORONARY ATHEROSCLEROSIS44030  ATHEROSCLEROSIS OF44031  ATHEROSCLEROSIS OF44032  ATHEROSCLEROSIS OFV4582  PERCUTANEOUS TRANSLUMINAL4353  VERTEBROBASILAR ARTERY41404  CORONARY ATHEROSCLEROSIS41405  CORONARY ATHEROSCLEROSIS41406  NATIVE CA OF TRANSPLANT H41412  DISSECT OF CORONARY ART44501  ATHEROEMBOLISM, UP EXTR44502  ATHEROEMBOLISM, LOW EXTR.44589  ATHEROEMBOLISM,OTHER44581  ATHEROEMBOLISM, KIDNEY41407  CORONARY ATHERO GRAFTSearch through the past full eight quarters claims (2 years) for a specific list of different diagnosis codes; The general codes are: 410.*, 412 Diagnosis CodeDiagnosis Description410  ACUTE MYOCARDIAL INFARCT4100  AMI ANTEROLATERAL WALL41000  AMI ANTEROLAT WALL-CARE N41001  AMI ANTEROLAT WALL-INIT C41002  AMI ANTEROLAT WALL-SUBS C4101  AMI ANTERIOR WALL NEC41010  AMI ANTERIOR WALL NEC-CAR41011  AMI ANTERIOR WALL NEC-INI41012  AMI ANTERIOR WALL-NEC-SUB4102  AMI INFEROLATERAL WALL41020  AMI INFEROLAT WALL-CARE N41021  AMI INFEROLAT WALL-INIT C41022  AMI INFEROLAT WALL-SUBS C4103  AMI INFEROPOSTERIOR WALL41030  AMI INFEROPOST WALL-CARE41031  AMI INFEROPOST WALL-INTI41032  AMI INFEROPOST WALL-SUBS4104  AMI INFERIOR WALL NEC41040  AMI INFERIOR WALL NEC-CAR41041  AMI INFERIOR WALL NEC-INI41042  AMI INFERIOR WALL-NEC-SUB4105  AMI LATERAL WALL NEC41050  AMI LATERAL WALL NEC-CARE41051  AMI LATERAL WALL NEC-INIT41052  AMI LATERAL WALL NEC-SUBS4106  TRUE POSTERIOR INFARCT41060  TRUE POSTER INFARC-CARE N41061  TRUE POSTER INFARC-INTI C41062  TRUE POSTER INFARC-SUBS C4107  SUBENDOCARDIAL INFARCT41070  SUENDOCARD INFARC-CARE NO41071  SUBENDOCARD INFARC-INIT C41072  SUENDOCARD INFARC-SUS CAR4108  MYOCARDIAL INFARCT NEC41080  MYOCARD INFARC NEC-CARE N41081  MYOCARD INFARC NEC-INIT C41082  MYOCARD INFARC NEC-SUBS C4109  MYOCARDIAL INFARCT NOS41090  MYOCARD INFARC NOS-CARE N41091  MYOCARD INFARC NOS-INIT C41092  MYOCARD INFARC NOS-SUBS C412  OLD MYOCARDIAL INFARCT Search through the past full four quarters claims for the diagnosis code of Angina Pectoris (413.*) on at least two different dates of service; Diagnosis CodeDiagnosis Description413  ANGINA PECTORIS4130  ANGINA DECUBITUS4131  PRINZMETAL ANGINA4139  ANGINA PECTORIS NEC/NOS For e. through g. below, please reference the following link:  HYPERLINK "P:\\Managed Care\\Change Orders\\1037\\02 - Analyze\\CVD_meds.xls" P:\Managed Care\Change Orders\1037\02 - Analyze\CVD_meds.xls Search through the past full four quarters claims for the diagnosis code of Angina Pectoris (413.*) at least once AND at least one prescription from the attached list of drugs; Search through the past full four quarters claims for drug claims from the attached list of drugs on at least two different dates of service; Search through the past full four quarters claims for at least two drug claims containing at least two different medications from the attached list of drugs; Search through the past full four quarters claims for a list of DRG codes. SAK DRGCDE DRGDRG Description94 0106  CORONARY BYPASS W CARDIAC CATH95 0107  CORONARY BYPASS W/O CARDIAC CATH108 0121  CIRC DISOR W AMI & CV COMP DISCH ALIVE109 0122  CIRC DISOR W AMI W/O CV COMP DISCH ALIVE470 0547  OTHER CARDIOTHORACIC PROCS W MAJOR CC471 0548  CARD PACEMAKER IMPLANT OR REVISION W MCC473 0550  OTHER VASCULAR PROCEDURES W MAJOR CC676 0109  CORONARY BYPASS W/O PTCA W/O CARDIAC 8.2.3 The stratification process consists of running additional queries on the members found during the selection process. However, these queries find total paid amounts for each member along with other summary data. This data is put through a formula created by Regeinstrief which calculates the risk value for each member. The new members are sent to ISDH along with their risk values to be loaded into CDMS. 8.2.3.1 Stratification data For each selected member, the following data fields must be determined. Recipient SAK Aid Category The aid category is converted to a numerical value determined by Regenstrief several years ago. The conversion table is listed below for reference: Aid CategoryAid category umberE-3.842078836N-1.565007824F-1.215559951M-0.317310904C0.35405362090.44355317820.686607700U1.204610968B1.220098267A1.367604131D1.578633108DW1.578633108R1.779922452Any others0.Dental Total Charge Sum of paid amounts on claims for the given time period for the specific member Pharmacy Total Charge Sum of paid amounts on claims for the given time period for the specific member Physician Total Charge Sum of paid amounts on claims for the given time period for the specific member UB92 Total Charge Sum of paid amounts on claims for the given time period for the specific member Total Charges Sum of all claim types totals HICL Count Count of unique hicls for the given time period Risk Value - Using the following formula and the fields above create the risk value: Formula: Risk Value = ( 1.566 + (0.552 * ln(total charges) ) + aid category number + (0.03375 * count of unique prescriptions) )/12 ) 8.2.3.2 Determining Risk Level In order to determine the risk level, the selected members must be sorted by risk value. The members with the top 20% of risk are considered high risk. The system must determine what the cut-off value is for each specific refresh. That data must be published to ISDH. 8.2.3.3 Stratification Outputs 8.2.3.3.1 A high risk file must be produced for ISDH. This file contains the RID followed by the pipe symbol and then the risk value and a carriage return. This file is to be FTPd to the CDMS server under the high_risk directory. 8.2.3.3.2 A test file of the new recipients along with current recipients must be sent to ISDH before the members can be loaded to production. Currently, the selected members are loaded to a disease management selection database table and a modified version of the daily update process is used to create the test file, which is ftpd to the CDMS server under the test directory. 8.2.3.3.3 A detailed member file/spreadsheet is sent to the enrollment broker on the high risk members only. The spreadsheet currently contains the following fields: RID Date of Birth Recip Language Recip County Disease Recip First MI Recip Last Recip Street1 Street2 City State Zip Zip4 Recip Phone ELIG IND (Y/N) indicates members currently eligibility status PMP ID Group ID Service Location PMP Name Group Name Prov Street1 Street2 City State Zip Zip4 Prov County Prov Phone Phone Ext 8.2.3.3.4 Once ISDH and the CMOs have completed testing the refresh, a date is set for the load to production. Currently, the daily file is produced at noon, Monday through Friday, therefore, the newly selected members must be added to the Disease Management database table before noon on the day in which ISDH wants to load the members. If the members are loaded with a start date of that day, the daily update process will pick the new members up and send them to ISDH. 8.2.3.3.5 An address file of the high risk, currently Medicaid eligible members is sent to the CMOs. 8.2.3.3.6 An address file of the low risk, currently Medicaid eligible members is sent to the CMOs. 8.2.3.3.7 The address files contain the following fields: RID Birth Date Member County First Name Middle Initial Last Name Member Address 1 Member Address 2 Member City Member State Member Zip Code Member Zip plus 4 Member Phone 8.2.4. A data file with the rendering provider information is sent the first of the month to ISDH. The data file includes the following fields: Rendering Provider ID Full Rendering Provider Name 8.2.5. Current manual processes of the opt-out, selection, and stratification will be continued until the automated process is implemented. Source: Acceptance Criteria: 9. Update IHCP Web site with Care Select information 9.1 Incorporate a new section for Care Select in the Managed Care section of the IHCP Web site. 9.2 Create a new Web page in the IHCP Web site for CMO reference information 9.2.1. Web page will be structured similar to the MCO Question and Answer site and will be accessible to the CMO users who have been provided the assigned password Source: Acceptance Criteria: 9.3 Incorporate new telephone number for Care Select as provided by the State into the IHCP Web site, member and provider letters, manuals, and other processes as necessary. Source: Acceptance Criteria: Assumptions: EDS is not required to generate automated notifications of new ICDMP members to the PMPs. The entire CDMS data file process can not be completely automated as result of coordination of data file testing with CDMS. Source: H8 requirements were reviewed on 3/2/07 5/25/07, 6/15/07, and 6/29/07and ?. See HLR for other sources. Acceptance Criteria: Automation and selection data processes will be reviewed with the external vendors and confirmed in IndianaAIM to ensure DM members are accurately reflected. THESE ARE STILL UNDER REVIEW. _______________________________________________________________ Consider the CDMS references as requirements Consider deleting the Medstat extract requirement from this section since covered under H7 Consider changing all other transition-type requirements to assumptions Consider documenting the following as assumptions: Data will be transitioned between old and new system. Yes, may want EDS to be more specific. EDS believes this should be removed. Any transition would be noted in requirements and/or communication plan. If needed would identify PA between CMO and HCE and edit location 22 for CMO and HCE. Please advise. Current functionality will be maintained at least through June 30, 2007 while new functionality is developed and integrated, and continue all of the current functionality until the program has gone state-wide. Yes Believe this should be documented as assumption vs. requirement. Please advise Changes will be evaluated for impact to the new Care Select Program and the Medicaid Select processes, which will be running until complete phase-in of the new program. Systematic and manual member assignments. Yes. Believe this is incorporated in requirements, as well as, the SLC process. Believe this should be removed. Please advise. Requirement Maintain MS program till cs program has been Generation of PCCM and PMP notices. Generation of PCCM administrative fees. Enrollment and dis-enrollment of PCCM PMPs, including consideration of OOS and IFSSA service locations. Consider deleting this requirement per being referenced in H7 Data for MedStat needs to include Care Select data. This is the Milliman extract, Yes. CDMS Confirmation w/State EDS previously sent out PMP notification letters. This process was discontinued due to providers dissatisfaction of multiple letters received. Are the letters still not required? EDS sends one year of claims history to CDMS on a yearly basis. Information used for researching purposes for physicians regarding ICDMP members. Do we need to send more frequently-Quarterly? Communication: A plan will need to be developed, for members, providers and advocacy groups. There will need to be new manuals, including modifications to the current IHCP provider manual and creating a Care Select reporting manual, among others Call center information will be needed. (question on incoming phone options) The web content site for Medicaid Select will need to be modified. Add on Care Selectany links. Review forms/letters for Medicaid Select to see if something similar for CS. Constraints: This will be a phased in implementation. Yes Assumptions: Providers will contract with the vendor. CM vendor payments will be made by the state, and the PMPM fee to PMPs will be made by EDS similar to how Med Select PMPs are paid Current training process for PMPs will be utilized for the new CM vendorthis may require additional trainings from EDS to be scheduled. (All) There will be minimal training of the PMPs by EDS on the CMO program. Except for Business Objects. CMO will do provider education as the MCOs do their provider education today. Without timely and accurate data from vendor, EDS will not be able to create reports. This needs to be addressed in the contract. What reports are currently generated for M-Select by EDS? Reports for P.A., AFI data, PMP enrollments. Schedule will be revised after detailed requirements are approved. (All) Yes Implementation of DLR under each HLR must occur concurrently (All) Yes Do not expect changes to State Plan, Indiana Code or Indiana Administrative Code. There will be a waiver submitted to CMS. There will be some changes regarding PA for Nursing facilities and MRO services, these will not impact the implementation. Provider profiling as UM tool performed by CM contractor. No support will be needed from Fiscal agent. Fiscal Agent Yes Modifications to auto assignment for members should be flexible for CS and MS, to forecast the phased implementation. Yes Risks: If behavioral health policy changes due to political considerations, then carve in may be delayed. Nursing Facility PA & MRO PA new 1/1/08, will not change carve-in. Depending on crosswalking National Provider ID (NPI) infrastructures to PMP IDs in AIM: reporting, and auto-assigning could be impacted and additional coding/changes may be required. Yes If vendor cannot complete the coding requirements in time, then Member and Provider services may be interrupted- although all claims will continue to go through EDS. Yes, be able to accept the 834. If other competing OMPP change order priorities take priority over this CO, then timeline delays are possible. CO 910 Hoosier Healthwise Procurement PIR activities These need to be completed. If this causes a delay, notice needs to be given immediately. CO 789 NPI Crosswalk project activities These need to be completed. If this causes a delay, notice needs to be given immediately. Family Planning Waiver may be of impact This should not take priority over these changes.Yes If contracting and policy definition progresses, then some functionality may be subject to change, then timeline delays are possible. If members are actively assigned as of 7/1/2007, then they must have assignments based on eligibility and new guidelines for 07/01/2007. If Business Object licenses are needed and not identified up front, then may issues getting them in timely manner (low) RFP for Takeover may impact delivery of project. The state feels any impact should be minimal. Questions still needing answers: How will the doctors be paid the $4 fee or whatever it is? Will this be tied to first claim or just having members on panel. Payment for M.S. PMPs will remain the same through the roll-out. The new fee of $15 will be tied to panel. How to segregate PCCM members from Care Select members? Yes, list them as Care Select. How to transition current members into Care Select? The state will need to detail how this is to happen. Will people be auto assigned to Care Select by aid category? Yes, at first. Are CHIP members impacted by this? No these are all HH members. Affected Areas (Business and Technical): Check all that apply: YesYes270/271 (AVR/Interactive)xPharmacyx270/271 BatchxPowerBuilder Securityx276/277 InteractivePowerBuilder Windows (AIM)x276/277 BatchPremium Vendor Services278 Prior AuthorizationxPrivacyx820 MCO/PCCM PremiumxProject Workbookx834 MCO/PCCM RostersxProvider Enrollmentx835 FinancialxProvider Servicesx837 ClaimsxQuality ManagementxBuy-InMemberxBusiness Support Team Medical Review Team (MRT)ClaimsxPre-Admission Screening and Resident Review (PASRR)Customer AssistancexPrior AuthorizationxData EntryProvider RelationsxDMCMXPublicationsxDrug RebateReferenceDecision Support System (DSS) or Business ObjectsReplacements (and Adjustments)xElectronic Data Interchange (EDI)ReportsxEarly Periodic Screening, Diagnosis, and Treatment (EPSDT)ResolutionsxFinanceRestricted CardxFirst StepsSecurityxHCISurveillance and Utilization Review (SUR)HIPAAThird Party Liability (TPL)IOC/LOCViking or ImagingIssues ManagementWeb interChange (applications)Managed CarexWeb site (content site)- possiblexManagement Administrative Reporting (MAR)xWritten CorrespondencexMedical PolicyOther (Business Objects)xMedicare Part DOtherNational Provider Identifier (NPI)OtherProcessing NeedsYesProcessing NeedsYesMass AdjustmentReprocessingCommunication NeedsYesTraining NeedsYesBanner PagexExternal StaffxBulletins ProviderxInternal StaffxBulletins Trading PartnersTrading PartnersBulletins MemberxProvidersxNewsletterxOtherCompanion Guide xOtherDisaster Recovery Plan?OtherBusiness Continuity PlanxOtherEDI Web Site Provider ImpactxOtherEDI Web Site Vendor ImpactxOtherOperating Procedures ManualxProvider ManualxUser GuidesxSystems DocumentationxOther (Managed Care/supplemental web)x Initial Review Recommendation (include justification for decline/cancelled i.e. when, why, date) : Accept CO _____ Decline CO as Written _____ Cancelled _____ Justification: Technical Scope: Initial Gross Technical Estimate: __________________________________________________ Initial Gross Business Estimate: _________________________________________________ Total Initial Gross Estimate: ___________________________________________________ Tools/SkillsYesTools/SkillsYesLBMSxPowerBuilderxCxInfrastructure (Networking, storage)Web / Java / Jscript / XML etcxDSS Oracle (table mods, SQL etc)xJob ScriptsxUpdate / Add Table DataxBusiness ObjectsxEDIxOtherCobolxOther Amendment History Last UpdateAuthorChange Description2/26/07Julie SlomaVersion 2 for DLR.3/1/07Beth LinginfelterUpdated per OMPP requirement meetings3/8/07Jenni AlbersUpdated per OMPP requirement meetings3/9/07Sue SchwomeyerUpdated per OMPP requirement meetings3/26/07Beth LinginfelterUpdated per OMPP requirement meetings4/17/07Julie SlomaUpdated per Analysts feedback.5/1/07Julie SlomaUpdated per OMPP feedback and CM BA feedback. Also included H8 for CDMS.5/11/07Julie SlomaUpdated H8 based on AIs.5/25/07Beth LinginfelterUpdated requirements under H1 per OMPP stakeholder review and under H2 per OMPP decision to increase enrollment broker role. Added auto-assignment requirements 2.10+ Updated requirements under H7 6/1/07Beth LinginfelterStrikethrough of requirements related to assigning HH eligibles to Care Select PMPs per OMPP email 5/29/07 to no longer include this population. Affectedct requirements: 1.1.3, 1.1.4 and 1.3.67/2/07Susan SchwomeyerUpdated requirements in H8 per final review from OMPP, ISDH and Regenstrief.7/17/07Susan SchwomeyerDeleted codes 405, 405.0, 405.01, 405.09, 405.1, 405.11, 405.19, 405.9, 405.91, 405.99 in requirement 8.2.2.5 per OMPP and Regenstrief.8/1/07Beth LinginfelterUpdates to H1, H2, H7     PAGE 1 < PAGE 7 > Detail Level Requirements Version 2.0, April 2006 EDS INTERNAL DOCUMENT < PAGE 1 > Requirements Version 1.0, April 2006 EDS INTERNAL DOCUMENT | Requirements Care Management >> #$2S1 2 ; > [ \ L M  ?  4 D W ~uqmiqqeh&=h9h*%s-F)Eƀ F...gdiF)Eƀ F...gdiF'Eƀ F..gdi>%%%%s-F)Eƀ F...gdiF)Eƀ F...gdiF)Eƀ F...gdi%&&'''']F$Eƀ FH gd pgdWrCgdXU^ ' & F8^8gdlF)Eƀ F...gdm'n) *K*iK$ & FEƀ F...gd<+K$ & FEƀ F...gdmI$ & FEƀ F..gdmK*X**gK$ & FEƀ F  .....gd<+K$ & FEƀ F  .....gd<+***gK$ & FEƀ F  .....gd<+K$ & FEƀ F  .....gd<+*6+7++YK$ & FEƀ F...gdi$ & F[^[gd<+K$ & FEƀ F...gd<+ *7+++{,V-]-^------t.v......////000011*1+11111$26292E2m2n22ƾ亲Љ亲ytotoy 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