LIHP Application Presentation 1-28-11 - California
更新时间:2023-06-11 11:04:01 阅读量: 实用文档 文档下载
- 李鸿章推荐度:
- 相关推荐
Low Income Health Program (LIHP) Application ProcessLIHP@dhcs.ca.gov
Welcome to the Department of Health Care Services (DHCS) LIHP Application Informational Meeting
- January 2011 -
Service - Accountability - Innovation
Staff introductions and organization
Service - Accountability - Innovation
Today’s Goal Overview of process - application, authorization, and implementation. Provide tips on how to complete the LIHP application. Provide technical support to help applicants become approved.4
Service - Accountability - Innovation
The Day at a Glance Housekeeping. Agenda. Questions & Answers. Summary.
Service - Accountability - Innovation
Ground Rules One person speaks at a time. No sidebar conversations. Respect each other’s time. Turn cell phones off or set to vibrate. Ask questions.
Service - Accountability - Innovation
Authorization Chapter 723, Statutes of 2010 (Assembly Bill 342). Welfare and Institutions Code Sections 14053.7 and 15909-15915. Penal Code Section 5072. Section 1115(a) Medicaid Demonstration (Demonstration), “Bridge to Reform”.
Service - Accountability - Innovation
LIHP Purpose Provides the opportunity to begin an early implementation of key coverage expansion components of the Patient Protection and Affordable Care Act. Promotes stability in the health care delivery system. Maximizes federal funds for low income adults care. Provides for increased efficiency in state and local health care funding. Promotes quality, value, and better health outcomes in the provision of health care services.8
Service - Accountability - Innovation
LIHP Consists of Two Programs Medicaid Coverage Expansion (MCE) is not subject to a federal funding cap and provides a broader range of health care services to eligible adults who are aged 19 to 64, with family incomes at or below 133% of the FPL, and may have insurance. Health Care Coverage Initiative (HCCI) is subject to a federal funding cap and provides health care services to eligible adults who are aged 19 to 64, with family incomes above 133 through 200% of the FPL and are uninsured.Service - Accountability - Innovation 9
Voluntary ParticipationApplicants voluntarily elect to participate.
Service - Accountability - Innovation
LIHP Conditions of ParticipationIf participating, the following conditions apply: MCE must be implemented. HCCI is optional. Inpatient hospital services, limited to only those services subject to FFP pursuant to Title XIX of the Social Security Act for individuals who are determined eligible by the State, must be provided by the local LIHP.
Service - Accountability - Innovation
Additional Conditions of Participation Non-federal share of the federal reimbursement must be provided by local, non-federal funds.
No State General Fund monies will be used to fund LIHP. The non-federal share of DHCS staffi
ng/administrative costs attributable to the cost of administering the local LIHP will be reimbursed by the local LIHP. - Questions Service - Accountability - Innovation 12
LIHP Application
Service - Accountability - Innovation
General Information Section #5 - Applicant typeApplicant must be one of the government entities listed to apply. County. City and County. Health Authority. Consortium of counties serving a region consisting of more than one county (Identify each participating county member).Service - Accountability - Innovation 14
General Information Section #6 - Implementation – MCE, HCCI, or both The proposed implementation date is an estimated date to help DHCS plan the implementation for each applicant. HCCI can not be implemented if MCE is not implemented. Counties with existing HCCI enrollees have the option to not implement the MCE and/or HCCI. These counties can not continue to enroll after this decision is made. They can provide health care services to their existing enrollees and receive reimbursement. - Questions Service - Accountability - Innovation 15
Provider Network Section
#7. Open or closed delivery system Application correction/addition: – Response changed to Open or Closed instead of prior Yes or No response. – Note: An applicant’s closed network is considered a managed care delivery system for LIHP. This closed network is subject to all applicable Medicaid laws and regulations, except those expressly noted in the STCs or the expenditure authorities for the Demonstration. With an open network, the LIHP would reimburse any provider who provided services to an enrollee.
Service - Accountability - Innovation
Provider Network Section #7. Open or closed delivery system
Closed network means the specific health care providers that are authorized by LIHP to provide health care services offered to enrollees in the LIHP. CMS considers a county based delivery system with a closed network of providers to be a managed care delivery system.
Service - Accountability - Innovation
Provider Network Section #7. Open or closed delivery system
This closed network is subject to all applicable Medicaid laws and regulations, except those expressly noted in the STCs or the expenditure authorities for the Demonstration.
Service - Accountability - Innovation
Provider Network Section #7. Open or closed delivery system
Expenditure Authorities: Sect. 1903(m)(2)(A)(vi)
Enrollees right to disenroll is restricted.
Service - Accountability - Innovation
Provider Network Section #7. Open or closed delivery system
Expenditure Authorities: Sect. 1903(m)(2)(A)(xii) Enrollees have a choice of at least two primary care providers, and may request change of primary care provider at least at the times described in Federal regulations 42 CFR 438.56(c). Enrollees don’t have a choice of at least two managed care organizations. Payment for out-of-netwo
rk emergency services may differ from the requirements in statute. Refer to payment allowances set forth in STC 63fi. Approved applicants must comply with the network adequacy requirements set forth in STC 72.
Service - Accountability - Innovation
Provider Network Section #7. Open or closed delivery system
Expenditure Authorities: Sect. 1903(m)(2)(A)(xii) State is not required to develop a quality strategy. Approved applicants must comply with the standards and requirements set forth in the STCs. External quality reviews not required. Not required to comply with limitation on marketing activities.
Service - Accountability - Innovation
正在阅读:
LIHP Application Presentation 1-28-11 - California06-11
2017年申论热点02-21
2023年监理工程师个人工作总结范文03-23
生物工程设备课程设计04-28
包饺子日记4篇10-29
醋酸氯己定凝胶剂的制备及质量控制05-24
综评经验分享09-12
如何写02-17
农村信用社安全保卫年度工作总结范文06-05
手糊玻璃钢施工工艺及要求03-14
- 1Application of wavelets and neural networks to diagnostic system development, 1, feature extraction
- 2Application of wavelets and neural networks to diagnostic system development, 1, feature extraction
- 3Sample_invitation_letter_to_provide_in_support_of_visitor_visa_application1
- 4presentation——美国文化
- 5如何做好presentation
- 6Application_Instructions
- 7Case-study Presentation Rubrics
- 8Lesson plan presentation - 整理
- 9Lesson plan presentation - 整理
- 10Verdi_HWSW_Debug_Customer_Presentation
- 教学能力大赛决赛获奖-教学实施报告-(完整图文版)
- 互联网+数据中心行业分析报告
- 2017上海杨浦区高三一模数学试题及答案
- 招商部差旅接待管理制度(4-25)
- 学生游玩安全注意事项
- 学生信息管理系统(文档模板供参考)
- 叉车门架有限元分析及系统设计
- 2014帮助残疾人志愿者服务情况记录
- 叶绿体中色素的提取和分离实验
- 中国食物成分表2020年最新权威完整改进版
- 推动国土资源领域生态文明建设
- 给水管道冲洗和消毒记录
- 计算机软件专业自我评价
- 高中数学必修1-5知识点归纳
- 2018-2022年中国第五代移动通信技术(5G)产业深度分析及发展前景研究报告发展趋势(目录)
- 生产车间巡查制度
- 2018版中国光热发电行业深度研究报告目录
- (通用)2019年中考数学总复习 第一章 第四节 数的开方与二次根式课件
- 2017_2018学年高中语文第二单元第4课说数课件粤教版
- 上市新药Lumateperone(卢美哌隆)合成检索总结报告
- Presentation
- Application
- California
- LIHP
- 28
- 11
- 梅州市物业管理行业研究报告
- 网页设计与制作教程期末考试简答题(小宝宝工作室)
- 卡介菌多糖核酸对复发性生殖器疱疹患者外周血T细胞IL-12表达的影响
- 罗默《高级宏观经济学》版课后习题详解 索洛增长模型
- 计算方法习题集及答案
- 建筑企业养老保障金收缴政策解读
- 【网络安全】保障个人电脑安全十点建议
- 语文版八年级语文上册《小石潭记》导学案
- 浙江省丽水市小学数学一年级下学期期中测试题一
- 衢州企业内训哪家好?
- 室内设计几大配色不死定律
- 罗盘导线测量记录计算表1
- 第三章《倍数与因数》2020年五年级数学上册北师大版
- 九大家居风水误区千万不可碰
- 2010解题能力展示复赛试题解答(中年级组)
- 2001年英语专业八级考试全真试卷及答案
- 学校社会工作介入高校贫困大学生心理健康问题研究
- 某框架办公楼-分部分项工程量清单(项目特征转行)
- 林清寺中学党支部2011年下半年工作安排
- 第三章 教师专业发展的过程