February 2019

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Spring Medicaid Fair 

The Department of Community Health (DCH) and DXC Technology encourage you to save the following date for our next Medicaid Fair!

Tuesday, April 23, 2019
Savannah Convention Center
Savannah, GA 31421

The Medicaid Fair will open with important updates on emergent issues by DCH Leadership and over a dozen break-out sessions will cover a variety of topics. The Care Management Organizations will be onsite to answer your questions. DCH and DXC Technology are also bringing back several 30-minute break-out sessions so you can get as much out of your Medicaid Fair day as possible. Please stay tuned for additional details and registration information which will be posted soon.

Do you want to help shape our agenda?

To ensure that our planned break-out sessions (including time for questions and answers) address relevant topics for you, please submit your suggested breakout topics to [email protected] no later than Friday, March 1, 2019. Based on your feedback the agenda will be developed and registration details will be posted.

Do you need more information about the Savannah Convention Center?
 
For location and directions to the Medicaid Fair, please visit the Savannah Convention Center website at:
 
 
Thank you for your continued participation in the Georgia Medicaid program.

We look forward to seeing you on, Tuesday, April 23, 2019  in Savannah!
The Georgia Department of Community Health's CenteringPregnancy® Incentive Program


Effective February 18, 2019, DCH will implement the CenteringPregnancy® Incentive Program pilot. CenteringPregnancy is a model group of prenatal care that has been associated with improved newborn and maternal health outcomes. The CenteringPregnancy Incentive Program is a one-year pilot designed to: increase prenatal care services, improve birth outcomes, and construct a statewide CenteringPregnancy sustainability model. DCH will work with the Georgia Department of Public Health and designated pilot locations to capture information relevant to building a CenteringPregnancy sustainability model. The CenteringPregnancy Incentive Program will provide additional reimbursement for providers to render services to Medicaid eligible women enrolled in a Care Management Organization. 
 
DCH has designated four facilities as pilot locations for the incentive program:

  1. Dougherty County Health Department
  2. Grady Health System
  3. Southside Medical Center - Lovejoy
  4. Upson Women's Services 
More information can be found at http://www.centeringgeorgia.org/index.htlm.  If you have questions, please email the CenteringPregnancy Incentive Program's project coordinator Anne Coleman at [email protected]


What's New With EVV?

 
The Georgia Department of Community Health is committed to adhering to the federal 21st Century Cures Act mandate which requires states to implement Electronic Visit Verification (EVV) to avoid an escalating reduction in their federal Medicaid funding. EVV is a technology that automates the collection of service information by home care workers at the point of care. EVV contributes to Georgia Medicaid's mission of providing access to affordable, quality health care services for Medicaid members. It offers advantages not only to Medicaid Members, but to their family caregivers and providers, such as case managers. EVV will address Medicaid fraud, waste and abuse by reducing billing errors and improving claims payment accuracy. Current alternative EVV system stakeholders have reported several benefits since implementing their new systems, which include:
 
  • Better Medicaid member outcomes through improved consistency of care delivery;
  • Improved service accountability and alignment across the care coordination team;
  • Reduced paperwork and manual processes associated with administrative processes;
  • More flexibility in performing tasks such as approving timesheets "on the go;"
  • Streamlined communications between provider and caregivers;
  • Alerts in the event of care deviations, such as late or missed visits; and
  •  Service dashboards with reporting capabilities.
 
The DCH EVV Project Team is ready to ramp up efforts towards implementing EVV across Georgia and will announce the EVV solution vendor soon! For more information on Georgia's EVV Program, please visit our dedicated EVV webpage or contact us at [email protected] if you have any questions.
Continuous Quality Improvement Initiative:
Streamlining Provider Enrollment Updates 

 
As part of the Georgia Department of Community Health (DCH) Continuous Program Improvement Initiative, DCH is streamlining the process for submitting provider enrollment updates. DCH is eliminating the need for providers to submit enrollment updates through multiple platforms.This change will eliminate duplication, ensure program integrity, and reduce administrative burden.

Effective immediately, all provider enrollment updates (individual practitioners and facilities) must be submitted through the Georgia Medicaid Management Information System (GAMMIS). The Care Management Organizations (Amerigroup, CareSource, Peach State Health Plan, and WellCare) will no longer accept provider enrollment updates that are not processed through GAMMIS. Failure to submit provider enrollment updates through GAMMIS may result in the delay of receipt of reimbursement.

All enrollment updates must be completed via the online change of information form, which can be accessed on the GAMMIS web portal at www.MMIS.georgia.gov using your username and password. The form is located under the provider link.
 
The online change of information form must be submitted when updating any of the following:
  1. Expired credentials (license, specialty certification, accreditation, certification or business license);
  2. Drug Enforcement Agency permit number;
  3. "Doing Business As" provider name;
  4. National Provider Identifier Number;
  5. Provider or Business Name;
  6. Service Location Address;
  7. Sponsoring Physician;
  8. Social Security Number (individual practitioners);
  9. Attestation of Compliance for providers who have received $5 million or more during the Federal Fiscal year;
  10. Deactivation of provider identification number (for providers who have voluntarily terminated their participation in the Georgia Medicaid/PeachCare for Kids®
     program);
  11. Adding provider contracts;
  12. Reactivation of participation if your enrollment file has been suspended due to no claims activity for 12 months;
  13. Retroactive enrollment request;
  14. Electronic Funds Transfer Account;
  15. Federal Employer Identification Number;
  16. Payee Address;
  17. Payee Affiliation; and
  18. Payee Name.
Instances when the online change of information form may not be used:
 
  1. "-Mail-to address updates: Mail-to address updates are to be completed via the demographic maintenance panel on the GAMMIS web portal using your username and password. The demographic maintenance panel is located under the provider link.
  2. Change of Ownership updates: A change of ownership includes, but is not limited to, a dissolution, incorporation, re-incorporation, reorganization, change of ownership of assets, merger, or joint venture whereby the provider either becomes a different legal entity or is replaced in the program by another provider. The new owner must submit an enrollment application via the GAMMIS web portal enrollment wizard. Failure to submit change of ownership updates through GAMMIS may result in delays in reimbursement.
  3. Owners and Managing Employee updates: Owners and managing employee updates are to be completed via the demographic maintenance panel via the GAMMIS web portal using your username and password. The demographic maintenance panel is located under the provider link.
  4. Patient Demographic Information: Providers may use the demographic maintenance panel to update patient demographic information such as:
    • Indicating that new patients are being accepted;
    • Identifying correspondence medium; and
    • Changes in office hours and accessibility.
Updates are to be completed via the demographic maintenance panel on the GAMMIS web portal using your username and password. The demographic maintenance panel is located under the provider link.
 
Should you require assistance or clarification on how to access the online change of information form or the Demographic Maintenance panel, please contact the DXC Provider Call Center at 1-800-766-4456.
2019 DCH Board Meeting Schedule
 
To view the entire Board of Community Health meeting schedule for 2019, 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 Planning in Georgia.      

 

Frank W. Berry 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
    
Purpose Statement

"Shaping the future of A Healthy Georgia by improving access and ensuring quality to strengthen the communities we serve."


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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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