Medicaid Local Match Program
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New AHCA Training on Medicaid Substance Abuse Codes [PDF]
(Medicaid Services for Substance Abuse:
Community Behavioral Health Services Coverage and Limitations Handbook)
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Substance Abuse Local Match Certification Program, Provider Q & A Manual [PDF]
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The Train-the-Trainer Program Manual was produced and used during the RWJ Resources for Recovery Grant in Florida. This was a collaboration between USF-FMHI and Mary Herkert, presenter/consultant who worked for AHCA-Medicaid in the past and Central Florida Behavioral Health Network during the grant. Jim Winarski
(FMHI) worked with Mary on the manual.
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DCF is closely reviewing this CSAT publication as part of their planning for Managed Care contracting and case rate reimbursement.
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Florida Medicaid Summary of Services FY 2004-2005
[PDF]
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DCF System Redesign
DCF System Redesign: Contracting with Community Managing Entities (PowerPoint)
DCF System Conversion and Medicaid Managed Care: The impact on provider contracting and reimbursement (PowerPoint)
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Consultant Resumés
- Barbara C. Corbett
Consultant available with expertise in HMO/ PPO
contract negotiation, Messenger Model negotiations for provider networks,
Infomation Systems for provider organizations, establishing networks as
Medicaid billing agents, and Tools for utilization management
- Thomas Lucking
Thomas Lucking has provided training and technical assistance to the State
office, provider networks and local agencies in Florida over the past 10
years. He specializes in helping behavioral health systems and providers
address the organizational dimensions of Transition. Areas of expertise
include: network development, clinical pathway development, planning,
marketing, and profitability improvement. Thomas Lucking has provided
behavioral health consultation services in 28 states as well. Previously,
he was CEO of a large provider agency in Michigan
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Useful Links
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Medicaid Services for Substance Abuse
Community Behavioral Health Services
Presented by Mary Herkert
PDF Document examines general Medicaid rules, specific CBH services and requirements, and revenue maximizing strategies.
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Managed Care
Organizations and Provider Networks: Challenges and Opportunities
Neal Cash, CEO
Community Partnership of Southern Arizona
November 7, 2003
PowerPoint presentation is an overview of the Arizona model of managed care and the challenges overcome to design the first public sector full-risk behavioral health care system in the United States.
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Implementation
of SB 2404: the Managed Care Timetable
PowerPoint presentation reviews the policy issues and provisions of the Florida Legislature's SB 2404.
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Senate Bill 1258 - Key Provisions
PDF document summarizes SB1258 in under three pages.
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Florida HMOs & Medicaid Information
PDF document is an FHA data brief that uses charts and graphs to illustrate HMO trends in Florida through March 31, 2004.
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Medicaid Made Friendly for Substance Abuse Treatment Providers:
Exploring Revenue Maximization Opportunities and Strategies
by Mary Herkert
Central Florida Behavioral Health Network
PowerPoint presentation provides a wealth of information in easy to read charts, including funding sources and reimbursable services by episode of care. Supplemental handouts [PDF] provided by FADAA.
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Evaluation
of Florida's Medicaid Prepaid Mental Health Plans: Year 6 Report
David L. Shern, Ph.D. and the Evaluation Team
Louis de la Parte Florida Mental Health Institute
June, 2003
PDF document: For the past six years, under contract with AHCA, the Louis de la Parte
Florida Mental Health Institute (FMHI), has conducted a series of integrated,
multi-method evaluation projects designed to assess the effects of the
Prepaid Mental Health Plan (PMHP) demonstrations on access, cost, quality,
and outcomes of services relative to alternative managed care arrangements,
and to the traditional financing arrangements that are in use in the rest
of the state.
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Evaluation Results of the Prepaid Mental Health Demonstration: Year 7 - Areas 1 and 6
David L. Shern, Ph.D. and the Evaluation Team
Louis de la Parte Florida Mental Health Institute
August 4, 2004
PowerPoint presentation is a briefing for the Substance Abuse and Mental Health Corporation.
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List of Florida Medicaid HMO's by Area
PDF document, updated January 15, 2004, is a list of Florida Medicaid Health Maintenance Organizations compiled by the Bureau of Managed Health Care.
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AHCA Managed Health
Care Monthly Enrollment Reports
AHCA web page with links to monthly enrollment reports composed of Excel spreadsheets and maps.
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Analysis of Medicaid Enrollees and Substance Abuse Billings by Area
Excel spreadsheet includes March, 2004 Medicaid enrollment and FY2001 Statewide Medicaid Billings (FMHI data).
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New State Initiatives in Medicaid and DCF Financing & Contracting
PowerPoint presentation is an evaluation of system changes mandated by the Florida Legislature, including MH/SA integration and inclusion of HMOs.
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2004 Legislative Action Re- Medicaid Contracting
Powerpoint
presentation is an overview of how the new legislation affects Substance Abuse and Provider Networks.
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Medicaid pre-paid plan RFP, District #1
PDF Document released June 1, 2001 by the Agency for Healthcare Administration
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Contracting with HMOs
PowerPoint presentation summarizes the history of substance abuse versus mental health treatment and how current trends in treatment affect delivery of substance abuse services, including detox services and inpatient vs. intensive outpatient programs.
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Medicaid Training Materials
Substance Abuse Medicaid Training: Listing of substance abuse codes and
their requirements, analysis of current billing practices, and methods of
maximizing services to Medicaid enrollees: Handouts from Training by Mary
Herkert, CFBHN, December, 2004.
Medicaid Billable Units [PDF]
Medicaid Revenue, Area 4 [PDF]
Medicaid Revenue, Area 4(2) [PDF]
Medicaid Revenue, Area 7 [PDF]
Medicaid Revenue, Area 9 [PDF]
Medicaid CBHS Changes Section III; Florida Administrative Weekly [PDF]
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Transcript: Medicaid and Managed Care (FADAA Forum Chat)
November 12, 2004
PDF document is a transcript of an online chat featuring Thomas E. Lucking, a nationally-recognized management consultant.
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Substance Abuse and Mental Health: Network Design
Celeste Putnam, Deputy Secretary
Substance Abuse and Mental Health, Department of Children and Families
PowerPoint presentation summarizes the benefits of an integrated system of behavioral health care for DCF clients and Medipass recipients.
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Evaluation
of Florida’s Mental Health and Substance Abuse System Redesign
Strategies: Year 1 Report
Neil Jordan Ph.D.
Julienne Giard M.S.W.
Pat Robinson M.S.W.
Rebecca Larsen M.S.P.H.
Mary Rose Murrin, M.A.
June 2002
PDF Document: Under contract with the Department
of Children and Families (DCF) and in accordance with the requirements
of Senate Bill (SB)1258, the Louis de la Parte Florida Mental Health
Institute (FMHI), University of South Florida, is conducting an ongoing
formative evaluation of the financing strategies authorized to be implemented
by the legislation. The demonstration sites that were selected were
DCF District 1, including Escambia, Okaloosa, Santa Rosa and Walton
Counties and DCF District 8, including Charlotte, Collier, Glades, Hendry
and Lee Counties. FMHI’s role is to help identify the most effective
methods and techniques used to manage, integrate, and deliver behavioral
health services as specified in the legislation. This report describes
the progress achieved during fiscal year (FY) 2001-2002.
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