June 18, 2020  |  Issue 5  |  Volume 5

 
Success Story
Amerigroup's CHAMP Program Helps Des Moines Family with Surgical Recovery
A referral from school officials to Amerigroup's CHAMP program helped a Des Moines family through a difficult time earlier this year.

In February 2020, the CHAMP (Changing Health: Amerigroup - Monroe Partnership) program flex fund aided the family's transition after one child suffered a difficult and extended surgical recovery.

Amerigroup received the referral from Monroe Elementary, part of the Des Moines Public School District. Staff members at Monroe work in partnership with Amerigroup to identify ways in which social drivers of health affect families of children who attend the school. 

The referral was for a family that was struggling financially and had other needs. School officials were not sure why the family's 7-year-old had received emergency care, and made a referral for CHAMP assistance.

The Amerigroup specialist performed an assessment in which the child's mother reported her son had recently undergone a very sensitive abdominal surgery and was suffering complications after being kicked twice by other boys in a way that harmed his healing process. The complications required a second surgery on March 13. The recovery time, care and focus put additional strain on the family. 

The Amerigroup specialist arranged for financial assistance, referred the mother to the relevant school principal to set up a meeting regarding her concerns, and connected the family to food resources.

The referral to the CHAMP program flex-fund ultimately provided the family with rental and utility assistance as well as gift cards for gasoline. Upon follow up with the family, the mother's stress level had decreased significantly due to CHAMP assistance, which allowed her to focus on her son's recovery. She
told Amerigroup she was very grateful for CHAMP, because the amount of assistance the family received would have been difficult to obtain through other community resources. Following the second surgery, the mother reported her son was recovering well.

This is just one example of work the MCOs do each and every day to help IA Health Link members get the the right care, at the right time, at the right place.

News and Announcements
COVID-19 Testing Available to Uninsured Individuals
The Families First Coronavirus Response Act (FFCRA) created a new Medicaid eligibility group for uninsured individuals. The new eligibility group, COVID-19 Testing, will provide a limited benefit package of services related to just testing and diagnosis of COVID-19 during the public health emergency. Services for treatment of COVID-19 will not be covered for the new eligibility group. 

Effective June 1, 2020, the IME started enrolling individuals in the COVID-19 Testing Group and will continue enrolling eligible individuals throughout the duration of the COVID-19 public health emergency. 

Uninsured individuals living in Iowa that wish to be tested for COVID-19, are encouraged to complete Form 470-5618: Application for COVID-19 Testing Coverage, to be tested for COVID-19 at no cost. Individuals are encouraged to complete the application electronically via the DHS website . 

Applications also may be submitted by mail, fax or telephone. Individuals can complete an application over the phone by calling the DHS Contact Center at 1-855-889-7985. Read Informational Letter 2141-CVD for more details.

Relief Fund Distributions for Medicaid and CHIP Providers
On June 9, the Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced additional distributions from the Provider Relief Fund to eligible Medicaid and Children's Health Insurance Program (CHIP) providers that participate in state Medicaid and CHIP programs.

According to the HHS, to be eligible for this funding,  health care providers must not have received payments from the Provider Relief Fund General Distribution and either have directly billed their state Medicaid/CHIP programs or Medicaid managed care plans for healthcare-related services between January 1, 2018, to May 31, 2020.

On June 10, 2020, HHS launched an enhanced provider relief fund portal that will allow eligible Medicaid and CHIP providers to report their annual patient revenue, which is used as a factor in determining their Provider Relief Fund payment.

More information about eligibility and the application process is available at https://www.hhs.gov/coronavirus/cares-act-provider-relief-fund/general-information/index.html

HHS is holding 2 webcasts next week for providers to learn more about the application process. Providers are encouraged to pre-register to reserve a spot.

Third-Party Liability Verification Update
The IME's Eligibility Verification System (ELVS) no longer provides third-party liability (TPL) verification for members assigned to a managed care organization (MCO) or dental pre-paid ambulatory health plan (PAHP).

MCOs and dental PAHPs will provide verified TPL information for their members. Providers should report TPL leads or changes for member's health insurance or dental coverage to the member's assigned MCO or dental PAHP. 

For Fee-for-Service member TPL verification, continue to use ELVS. TPL leads or changes for members in FFS should be reported using form, 470-5445.

Electronic Visit Verification (EVV) Update
A presentation regarding the IME's managed care implementation model is available on the DHS website, as well as answers to several frequently asked questions.

Future information will be posted on the EVV webpage.

Public Notice
The following public notice has recently been posted on the Department of Human Services (DHS) website:

IA Health Link Contacts
MEMBER SERVICES

1-800-600-4441

1-833-404-1061
PROVIDER SERVICES

1-800-454-3730

1-833-404-1061

Dental Wellness Plan Contacts
MEMBER SERVICES

1-888-472-2793

1-855-247-6262
PROVIDER SERVICES

1-888-472-1205

1-855-856-6262

Iowa Medicaid Contacts
1-800-338-8366

PROVIDER SERVICES

1-800-338-7909



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