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|August 23, 2018
NEW SMMC PROGRAM GOALS
Medicaid New Five-Year Contract Begins January 1, 2019
This is a goal of the current SMMC contract but, has been given further emphasis within the new SMMC contract. It is evident by the requirements of the contract and the negotiation and award process the Agency will place special emphasis on this goal. Further, the health plans are offering additional expanded benefits related to the transitioning of appropriately approved nursing home residents into HCBS. Some of this increase in HCBS will be realized through Assisted Living placement or the ability to age in place due to increased services to the home. These services include home delivered meals, housing assistance, home care services, aide services, home health and other expanded benefits.
The overall state Medicaid LTC average for those residing in a nursing home is 43% with 57% residing in a HCBS setting. South Florida has the highest percentage of Medicaid LTC within the HCBS setting. The HCBS participation percentage has steadily increased since the inception of the SMMC program in 2013.
If you have questions, please contact Dana McHugh via email or by calling her at (850) 339-2909.
Training Webinars Scheduled for the Fall to Meet Requirements of the SMMC Contract
RIPPED FROM THE HEADLINES
Skilled Nursing Stuck in Awkward Middle Between Old and New Payment Models. Narrowing networks of referral providers have been a top concern for skilled nursing facilities over the last two years, with industry leaders preaching the importance of improving certain metrics in order to impress hospitals and home health agencies. Read more...
Health plan updates
Updates to Availity Gateway Improve Processing Experience. Updates to the Availity Gateway, effective August 18, 2018 release, will decrease claim holds and allow for a more seamless processing experience. Read more...
Electronic Fund Transfer (EFT) – Molina has partnered with ProviderNet for EFT. Access to the ProviderNet portal is FREE to our participating providers and we encourage you to register after receiving your first check from Molina.Read more...
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