Missouri Medicaid Audit & Compliance » From The Director Archives Archives

Public Notice

November 8th, 2024

Based on the actions of the Centers for Medicare and Medicaid Services, notice is hereby given that the agreement between the Missouri Department of Social Services and Festus Manor as a provider of services in the MO HealthNet (Medicaid) program, will be terminated at the close of business November 23, 2024.

To facilitate the orderly relocation of MO HealthNet beneficiaries, for residents admitted August 6, 2024, or earlier, payment may continue for up to 30 days for services furnished after November 23, 2024.

Todd Richardson, Director

MO HealthNet Division

Department of Social Services

Tracy Niekamp, Administrator

Section for Long-Term Care Regulation

Department of Health and Senior Services

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ELECTRONIC SIGNATURE REQUIREMENTS

November 8th, 2024

All forms submitted to MMAC must have an original handwritten signature or a verifiable electronic signature using an electronic signature software such as; DocuSign,Adobe Sign, DropBox Sign.Some of these software offer free limited accounts.

If in the course of reviewing your documents an unverifiable or altered form utilizing electronic signature is found or suspected, providers will be required to either submit the original documents showing the authentication trail meeting the requirements below or produce new forms with valid handwritten signatures.

All Medicaid providers using electronic signatures must meet the following requirements:

• Implement a reliable method of verifying the identity of the signing party. To ensure the validity of the electronic signature, the provider must produce the digital certificate or any other tracking trail document showing the authenticity of the signature. The certificate should include but not limited to: Signing E-mail address, time stamp, IP addresses.

• Retain the certified and unaltered original documents and the Certificate of Completion for a minimum of five (5) years. The electronic document and signature should be kept secure to preserve its integrity by preventing unauthorized changes and maintaining the completeness of the agreement. DocuSign, Adobe Sign, and Dropbox Sign files are subject to the document retention requirements outlined in the provider’s Title XIX Participation Agreement, 13 CSR 70-3.030(3)(A)(4), and the appropriate MO HealthNet Provider Manual.

For questions, contact MMAC.

Tags: electronic signature, signature requirements
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MO HealthNet Providers: Call Us For FREE!

October 8th, 2024

The Mo HealthNet Provider Communications Unit assists providers with eligibility and coverage verification, enrollment status, annual review dates, questions regarding proper claim filing, claims resolution and disposition, billing errors, verifying check amounts, and more.

Providers are encouraged to communicate with Provider Communications using the Provider Communications Management tool in eMOMED. Providers may also call the Interactive Voice Response (IVR) system at (573) 751-2896.
Beginning today, providers can also call Provider Communications TOLL FREE at (833) 222-7916. The caller must have the provider’s National Provider Identifier (NPI). The IVR system allows a MO HealthNet provider six options:

Press 1 for MO HealthNet Participant Eligibility
Press 2 for Check Amount Information
Press 3 for Claim Information
Press 4 for Provider Enrollment Status
Press 5 for MO HealthNet Participant Annual Review Dates
Press 6 to Speak to a Representative for Other Issues

For more information on the IVR system, review Section 3.3 of the General Sections Manual. For questions, contact MHD.Education@dss.mo.gov.

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4TH ROUND TESTING FOR THOSE WHO MISSED OR DIDN’T PASS THE FIRST AND SECOND ROUNDS, NEW CDS PROVIDERS – CONSUMER DIRECTED SERVICES (CDS) MANAGER REQUIREMENT – PER 19 CSR 15-8.400(1)D

August 12th, 2024

4TH ROUND TESTING FOR THOSE WHO MISSED OR DIDN’T PASS THE FIRST AND SECOND ROUNDS, NEW CDS PROVIDERS APRIL/MAY – CONSUMER DIRECTED SERVICES (CDS) MANAGER REQUIREMENT – PER 19 CSR 15-8.400(1)D

PLEASE READ TO THE END

Per the updated CDS regulation (19 CSR 15-8.400(1)(D), all CDS providers are required to have a Certified CDS Manager. Please see the original FROM THE DIRECTOR notification https://mmac.mo.gov/cds-manager-testing/ posted to the MMAC website on March 8, 2024.

No GRANDFATHERING – ALL CDS providers MUST HAVE a Certified CDS MANAGER who has passed this test. If you or one of your employees has attended the CDS Orientation or passed and/or is currently an In-Home Services Designated Manager – neither of these will apply nor be used for passing the Certified CDS Manager test. ANY PAST TRAININGS WILL NOT APPLY TO MEET THIS REQUIREMENT.

For those who did not attend or pass the first three rounds of testing, newly enrolled or pending:

The ONE person who will be the CDS Manager will be allowed to sign up to take the test
Register for ONLY ONE of the test dates below that best fits their schedule
Registration links will be emailed to the providers – DO NOT share the link with anyone else

DO NOT register for all three dates or register more than one person, please mark your calendars.

Test Dates

Thursday, August 22, 2024

Wednesday, August 28, 2024

Tuesday, September 3, 2024

Thursday, September 12, 2024

Emails with the link to register will go out to those CDS providers not compliant, newly enrolled or pending, Thursday August 15, 2024. The email will be sent to the business email on file with MMAC/MO HealthNet.

First three rounds had some issues with registration and emails, please refer to the WebEx Instruction link for tips and tricks regarding registration and confirmation emails. Registration Instructions: https://mmac.mo.gov/wp-content/uploads/sites/11/2024/01/CDS-Webinar-Instructions.pdf

The virtual testing sessions will start at 9:00 am, please allow 4 hours (1 hour presentation – reason for testing, current trends, quick break, overview of how the test will look, open book material and 3 hours for the test).

Open Book Materials for test: https://mmac.mo.gov/providers/provider-enrollment/home-and-community-based-services/open-book-dm-testing-materials/

Questions regarding the CDS Manager Test can be sent to MMAC.IHSCONTRACTS@DSS.MO.GOV

Tags: CERTIFIED CDS MANAGER TESTING
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PUBLIC NOTICE

July 8th, 2024

Based on the actions of the Centers for Medicare and Medicaid Services, notice is hereby given that the agreement between the Missouri Department of Social Services and Senath South Health Care Center as a provider of services in the MO HealthNet (Medicaid) program, will be terminated at the close of business July 25, 2024.

To facilitate the orderly relocation of MO HealthNet beneficiaries, for residents admitted April 24, 2024, or earlier, payment may continue for up to 30 days for services furnished after July 25, 2024.

Todd Richardson, Director

MO HealthNet Division

Department of Social Services

Tracy Niekamp, Administrator

Section for Long-Term Care Regulation

Department of Health and Senior Services

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PERM

June 18th, 2024

The Centers for Medicare & Medicaid Services (CMS), in partnership with the States, is measuring improper payments in the Medicaid and Children’s Health Insurance Program (CHIP) programs under their Payment Error Rate Measurement (PERM) process.

CMS and its PERM contractor, Empower AI, have begun sending medical records requests effective June 6, 2024. These requests will be sent directly to Missouri Medicaid/CHIP providers for claims billed during state fiscal year 2024. Empower AI will also be contacting providers directly to obtain contact information to ensure that the medical records request is sent to the correct contact/location. Please be sure to comply with any contact information requests and medical record requests. Additional information about the PERM program is addressed on the CMS PERM website (https://www.cms.gov/PERM). Refer to the “Providers” link on the website.

Federal regulations require that Medicaid/CHIP providers submit the medical record documentation to support claims for Medicaid/CHIP services to CMS upon request. Providing medical records for Medicaid/CHIP patients does not violate the Health Insurance Portability and Accountability Act (HIPAA). Patient authorization is not required to respond to this request. CMS and its contractors will comply with the Privacy Act federal regulations governing the sharing and transmission of Protected Health Information (PHI).

Questions regarding the PERM audit may also be directed to the State PERM representative Joyce Chandler at 573-751-7993 or please email MMAC.PERMAUDITS@DSS.MO.GOV.

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3RD ROUND TESTING FOR CERTIFIED CONSUMER DIRECTED SERVICES (CDS) MANAGER REQUIREMENT – PER 19 CSR 15-8.400(1)D

June 6th, 2024

3RD ROUND TESTING FOR THOSE WHO MISSIED OR DIDN’T PASS THE FIRST AND SECOND ROUNDS, NEW CDS PROVIDERS APRIL/MAY – CONSUMER DIRECTED SERVICES (CDS) MANAGER REQUIREMENT – PER 19 CSR 15-8.400(1)D

PLEASE READ TO THE END

For those who did not attend or pass the first or second round of testing or newly enrolled April/May 2024:

The ONE person who will be the CDS Manager will be allowed to sign up to take the test
Register for ONLY ONE of the test dates below that best fits your schedule
Registration links will be emailed to the providers – DO NOT share the link with anyone else

DO NOT register for all three dates or register more than one person, additional registrations will be rejected. The schedule below is based on currently enrolled CDS providers as of March 2024 who did not make it through the first round of testing. Mark your calendars for the dates based on your NPI.

Test Dates

Tuesday, June 25, 2024

Wednesday, June 26, 2024

Thursday, June 27, 2024

Emails with the link to register will go out to those CDS providers not compliant or newly enrolled on Monday, June 10, 2024. An email with the registration link will be sent to the business email on file with MMAC/MO HealthNet the week before the scheduled test date

First and second rounds had some issues with registration and emails, please refer to the WebEx Instruction link for tips and tricks regarding registration and confirmation emails. Registration Instructions: https://mmac.mo.gov/wp-content/uploads/sites/11/2024/01/CDS-Webinar-Instructions.pdf