SMMC Long-term Care Provider Webinar: Plan of Care


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This webinar covers the Plan of Care and recipient information data upload procedures.

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SMMC Long-term Care Provider Webinar: Plan of Care

  1. 1. Welcome to the Agency for Health CareAdministration (AHCA) Training Presentationfor the Recipient Information Data Upload.The presentation will begin momentarily.Please dial in ahead of time to:1-888-670-3525Passcode: 771-963-16961
  2. 2. Statewide Medicaid ManagedCare Long-Term Care Program(SMMC LTC)Recipient Information Data UploadTrainingMay 29, 20132
  3. 3. Today’s PresentationFollow the link below to theSMMC Website andSelect the “News andEvents” tab under theheader image.Note: You can also use thered button to sign up forSMMC Program updates viae-mail.
  4. 4. Today’s Presentation, cont.Select “Event and TrainingMaterials” to downloadtoday’s presentation.Note: You may also viewdetails regarding futureSMMC events using the“Upcoming Events” tab.4
  5. 5. Today’s Presentation, cont.Choose the file(s) youwould like to save.Note: You may also viewfiles from past events andAHCA guidancestatements or submitquestions to be answeredin future presentations.5
  6. 6. Today’s Presenter• Eunice Medina– Department of Elder Affairs6
  7. 7. Overview• To discuss:– Purpose for file upload,– File upload contents,– Receiving FTP access,– Step-by-step file upload instructions, and– Recipient information transfer.7
  8. 8. Background• Recipients in the following programs must transition fromtheir existing waiver or Frail Elder program into the StatewideMedicaid Managed Care Long-Term Care (SMMC LTC)Program:– Aged and Disabled Adult (ADA) Waiver,– Assisted Living (AL) Waiver,– Channeling (CHL) Waiver,– Frail Elder Program, and– Nursing Home Diversion (NHD) Waiver.8
  9. 9. Purpose and Goals• In order to ensure there is no disruption in services for existingwaiver recipients transitioning into SMMC LTC, the followingactions are contractually required for existing Nursing HomeDiversion MCOs and waiver case management agencies:– Existing providers (case managers and related staff) mustupload current care plans and service authorizations for allexisting waiver and Frail Elder Program recipients to theState.– Each SMMC LTC MCP must retrieve the information andact to ensure and guarantee the continuation of eachrecipients’ current services for up to 60 days OR until therecipient receives a new assessment and a new plan of careis developed and agreed upon with the enrollee.9
  10. 10. Current Provider Assistance• In order for the SMMC LTC MCPs to ensure the continuationof waiver services for existing waiver recipients, all Diversionand Frail Elder Managed Care Organizations (MCOs) andADA and AL Case Management Agencies (CMAs) currentlyauthorized to provide waiver services must assist by uploadingspecific client information to be shared by AHCA with theSMMC LTC MCPs.• This requirement outlined in their respective sub-contracts oragreements to provide waiver services and will be explained intoday’s presentation.10
  11. 11. Recipient Data Upload• Active recipients currently receiving services through thefollowing waivers will be included in the data upload:– Aged and Disabled Adult (ADA) Waiver,– Assisted Living (AL) Waiver,– Channeling (CHL) Waiver,– Frail Elder Program, and– Nursing Home Diversion (NHD) Waiver.11
  12. 12. File Upload Instructions:Recipient Information• Prior to uploading the requested recipient information, eachMCO/CMA will receive a list of the following informationfrom your State contract manager for all current recipients:• SSN• Date of Birth• First Name• Last Name• Provider Service Area (PSA)• MCO/CMAs will need to check this list against their recipientrecords and report any missing recipients and/or discrepanciesin recipient information to your State contract manager.12
  13. 13. Recipient Information Upload• The following recipient file information must be combinedinto one PDF document for each recipient and uploaded to ajoint AHCA/DOEA File Transfer Protocol (FTP) website:– Current Care Plan,– Current Service Authorizations (for fee-for-service providers),and– 701B assessment (optional).• For example, if your MCO/CMA has 50 recipients, you willhave 50 PDF submissions; one for each recipient.13
  14. 14. Naming Convention• The PDF document submitted for each recipient must have thefollowing naming convention: SOCIALSECURITYNUMBER_DATEOFBIRTH(MMDDYYYY)• For example, If waiver recipient John Doe’s SSN is 123-45-6789 and his birth date is January 21, 1931, then his filewould be named “123456789_01211931”.14
  15. 15. Receiving Access to the FTP site• Each MCO/CMA was required to submit the name and emailaddress of one designated staff person to serve as the singlepoint of contact for the file upload to the DOEA email• DOEA will send the list of contacts to AHCA, so that AHCA cangenerate the Username and Password for each designatedcontact person.• Before the file upload start date for each PSA/Region, eachMCO/CMA’s designated staff person will receive a Usernameand Password from AHCA in order to access the FTP site fortheir MCO/CMA.15
  16. 16. FTP Upload ScheduleFTP Upload SchedulePSA/Region Upload Begins Upload Deadline7 April 1, 2013 June 1, 20138 and 9 May 1, 2013 July 1, 20132 and 10 July 1, 2013 September 1, 201311 August 1, 2013 October 1, 20135 and 6 October 1, 2013 December 1, 20131, 3, and 4 November 1, 2013 January 1, 201416
  17. 17. Steps for FTP Access• Once the MCO/CMA designated contact person has received anassigned Username and Password, please take the followingsteps to successfully upload your recipient data files:• Step 1: Go to• Step 2: Save the compressed FileZilla FTP client folder bychoosing “save” not “open”, and save the file to your hard drive.• Step 3: Once downloaded, double click the FileZilla icon toopen the site manager.17
  18. 18. Steps for FTP Access: Step 4Click on “File” toselect the “SiteManager” option18
  19. 19. Steps for FTP Access: Step 5Click the“New Site” Button19
  20. 20. Steps for FTP Access: Step 6Change thesettings tomatch thisscreenshot andtype in yourUser Name andPassword thatwas
  21. 21. Steps for FTP Access: Step 7Click “Connect”to connect to theFTP site. If themessage belowopens in awindow after youclick “Connect,”click the “OK”
  22. 22. Steps for FTP Access: Step 8You will see a filewith your UserName. Click onthis folder toopen.22
  23. 23. Steps for FTP Access: Step 9Once in your folder, click on the PSA folder towhere you want to upload the recipient’s file.23
  24. 24. Steps for FTP Access: Step 10Drag file from yourcomputer to thiswindow.Once in thecorrect PSAfolder, dragand drop therecipient’s filefrom yourcomputeronto theworkspace totransfer.24
  25. 25. Data Upload Activities by the State• After the data upload has been submitted by each MCO/CMA,AHCA/DOEA staff will review the updated data to ensure thatthe required documents have been included for all currentwaiver recipients.• Once file uploads are confirmed, AHCA will provide eachrecipient’s data file to the new MCP for that recipient.25
  26. 26. Resources Questions can be emailed Updates about the StatewideMedicaid Managed Care programare posted at: Upcoming events and news can befound on the “News and Events” tab. You may sign up for our mailing list byclicking the red “Sign Up for ProgramUpdates” box on the right hand side ofthe page.26
  27. 27. Questions?