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Payment Error Rate Measurement (PERM) Program
Georgia is one of 17 states selected by the Centers for Medicare and Medicaid Services (CMS) for the PERM initiative for Federal fiscal year (FFY) 2016 (October 1, 2015 - September 30, 2016). Under this plan, a state will be selected for error rate measurement once every three years for each Medicaid and State Children's Health Insurance Program.
For FFY 2016, CMS will measure PeachCare for Kids® claim payments and premium payments made on behalf of beneficiaries for accuracy.
If a claim is selected for review for a service that you rendered, A+ Government Solutions, LLC/CNI Advantage, LLC will contact you to request a copy of your medical records to determine if the claims were correctly paid. It is critical that providers supply information on sampled claims in a complete and timely matter. Non-compliance will result in a claim adjustment against the provider's claim with the monies being recovered by Georgia Medicaid.
We recognize providers are concerned with maintaining the privacy of patient information. However, providers are required by Section 1902(a)(27) of the Social Security Act to retain records necessary to disclose the extent of services provided to individuals receiving assistance and provide CMS (through A+ Government Solutions, LLC/CNI Advantage, LLC) with information about any payments claimed by the provider for rendering services. Providing information includes medical records. Also, the collection and review of protected health information contained in individual-level medical records for payment review purposes is allowed by the Health Insurance Portability and Accountability Act (HIPAA) and implementing regulations at 45 Code of Federal Regulations, parts 160 and 164. The records do not need to be de-identified.
Results of the study will be published upon its completion.
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DCH To Host Public Comment Forum on Provider Credentialing and Verification Process
DCH is pleased to announce a public comment opportunity to gather input on the agency's new centralized provider credentialing and verification process. DCH is currently preparing to conduct a future procurement to establish a new contract for credentialing and verification services. DCH is seeking input from community stakeholders and partners all across Georgia for ideas to consider in program improvement and innovation.
DCH will host two public meetings to receive public comments:
- Monday, June 20, 2016 from 10:00 am to 12:00 pm in the DCH 5th Floor Board Room located at 2 Peachtree Street NW, Atlanta, GA 30303; and
- Wednesday, June 22, 2016 from 10:00 am to 12:00 pm at the State Office of Rural Health located at 502 Seventh Street South, Cordele, GA 31015.
Written comments may also be submitted via email to [email protected] through Thursday, June 30, 2016. View DCH's public notice for more information.
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GA Medicaid EHR Incentive Program
Boot Camp
The Georgia Department of Community Health, Division of Health IT, is hosting a free boot camp session for Medicaid providers interested in participating in the Georgia Medicaid EHR Incentive Program.
The boot camp will be held
Wednesday, July 13 at the
Collins Hills Branch Library at 455 Camp Perrin Road, Lawrenceville, GA 30042 from
1:00 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 Stages 1 & 2
- Audit prevention and preparation
- Connecting to a Health Information Exchange (HIE)
Registration is required. To register for the boot camp, click
HERE
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Community Care Services Program (CCSP) Transferring to DCH
Effective July 1, 2016, administration of the Community Care Services Program (CCSP) will be transferred from the Department of Human Services (DHS) to the Department of Community Health (DCH). Both agencies are working together to ensure this is a smooth transition.
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.
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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
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 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.
Send us your questions at
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