July 2016 

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DCH to extend existing Medicaid CMO services through June 30, 2017

The Georgia Department of Community Health (DCH) will exercise the second of two six-month contract extensions for Medicaid Care Management Organization (CMO) services with Wellcare of Georgia, Amerigroup Community Care and Peach State Health Plan for the period January 1, 2017 through June 30, 2017. The first contract extensions with the CMOs cover the period July 1, 2016 through December 31, 2016. DCH chose this course of action in an effort to ensure a seamless transition and implementation of new CMO contracts with no disruption of services to current members.

In 2015, the Department of Administrative Services (DOAS) posted a request for proposals (RFP) for new contracts with CMOs for the Georgia Families and Georgia Families 360° programs. DOAS issued a notice of intent to award new contracts to incumbents Wellcare of Georgia, Amerigroup Community Care and Peach State Health Plan, as well as one new vendor CareSource. The DOAS decision on the winning bidders for the new CMO contracts was appealed. For information regarding the appeals process, please contact Dana Harris, DOAS State Purchasing Division at dana.harris@doas.ga.gov.

For further information on the Georgia Families and Georgia Families 360 ° programs, please visit https://dch.georgia.gov/georgia-families or https://dch.georgia.gov/foster-care-adoption-assistance-juvenile-justice-%E2%80%93-georgia-families-360.

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State Fiscal Year 2017 HB 751 - PCP Attestation Rate Increase (Fee-For-Service [FFS] and CMO Providers)

The Georgia Department of Community Health (DCH) provides below an update to the pending PCP rate increases for thirty-two (32) procedure codes that were approved by the Georgia General Assembly in 2016. The rate tables also established the reinstatement of differential pricing between office and non-office based sites for primary care providers (PCP) and obstetrical and gynecological (OB/GYN) practitioners. This rate increase must be reviewed and approved by the Centers for Medicare and Medicaid (CMS) before the Georgia Medicaid Management Information System (GAMMIS) is configured for payments.

Click HERE to read the full article.

The Enhanced Fee Schedules and the Enhanced Non-Office Site of Service Differential for Outpatient Services for both PCPs and OB/GYNs can be found by clicking HERE.


Selection of RAC Provider Relations (RPR) Committee Members for State Fiscal Year (SFY) 2017

Myers and Stauffer LC ("MSLC") serves as the Medicaid Recovery Audit Contractor (RAC) for the State of Georgia Department of Community Health (DCH or Department). In this capacity, Myers and Stauffer performs audits of provider claims for various categories of service for the purpose of identifying and recovering overpayments for the Medicaid program and restoring underpayments to providers.

Under Federal law and the RAC contract, Myers and Stauffer is also responsible for assisting DCH in the promotion of provider outreach and education. For this purpose, the Department and Myers and Stauffer established a RAC Provider Relations (RPR) Committee to solicit input from the provider community on the general policies and practices governing RAC audits.

Nominations for the provider members of the RPR Committee for SFY 2017 (July 1, 2016-June 30, 2017) are currently being received.

Anyone interested in nominating a provider to serve on the RPR Committee should send a letter of interest by August 1, 2016 to:

Linda Wiant, Director
Medicaid Division
Georgia Department of Community Health
2 Peachtree Street, NW - 36th Floor
Atlanta, GA 30303

This letter must include the nominee's title or position, health care experience and reason for interest in the Georgia Medicaid RPR Committee. Please include "RPR Committee" on the subject line.

Click HERE to read the full article.
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GA Medicaid EHR Incentive Program
Boot Camp 

The Georgia Department of Community Health, Division of Health IT, is hosting several free boot camp sessions for Medicaid providers interested in participating in the Georgia Medicaid EHR Incentive Program.

The next boot camp will be held Wednesday, July 27 at the Columbus Public Library (auditorium) at 3000 Macon Road, Columbus, GA 31906 from 10:30 a.m. to 12:30 p.m and 1:30 p.m. to 3:30 p.m.

Eligible providers with a Medicaid patient volume of at least 30 percent can receive up to $63,750 during their six years of program participation. The boot camp offers free one-on-one assistance with:
  • Selecting a certified EHR system
  • Patient Volume Calculator
  • Meaningful Use Modified Stage 2
  • Adopt, Implement or Upgrade (AIU)
  • Audit prevention and preparation
  • Connecting to a Health Information Exchange (HIE)
Registration is required. To register for the boot camp in Columbus, click  HERE . Another boot camp will be held in Augusta, GA on August 4, and more information about that event is coming soon.

Visit dch.georgia.gov/ehr to learn more about the Georgia Medicaid EHR Incentive Program.
Community Care Services Program (CCSP) Transferred to DCH


As of July 1, 2016, administration of the Community Care Services Program (CCSP) has been transferred from the Department of Human Services (DHS) to the Department of Community Health (DCH).

CCSP is a Medicaid waiver program that provides a range of community-based services to assist individuals who are older and/or have disabilities to achieve safe, self-reliant lives.

DCH has developed FAQs for both members and providers
2016 DCH Board Meeting Schedule
 
To view the entire Board of Community Health meeting schedule for 2016, as well as actions taken at previous DCH Board meetings, click HERE.

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About DCH

 

2 Peachtree

 

Through effective planning, purchasing and oversight, the Department of Community Health (DCH)  provides access to affordable, quality health care to millions of Georgians, including some of the state's most vulnerable and underserved populations.

 

 DCH is responsible for Medicaid and PeachCare for Kids,® the State Health Benefit Plan, Healthcare Facility Regulation and Health Information Technology in Georgia.      

 

Clyde L. Reese III, Esq. is Commissioner of the Georgia Department of Community Health.  

 

We are dedicated to
A Healthy Georgia
.   

   

www.dch.georgia.gov 

 

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DCH-i

    

DCH Mission

 

We will provide Georgians with access to affordable quality health care through effective planning, purchasing and oversight.

We are dedicated to
A Healthy Georgia.


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About DCH-i

DCH-i is the bi-monthly newsletter from the Georgia Department of Community Health for all matters DCH. It provides timely and important information to you as physicians, dentists, hospitals, third-party payers, vendors and health care advocates.

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