GOVERNMENT OF THE DISTRICT OF COLUMBIA Department of Health Care Finance -*** Office of the Senior Deputy/State Medicaid Director Transmittal# 17-28

To: District of Columbia Medicaid Managed Care Organizations (MCO)

From: Claudia Schlosberg, Esq. ~S Senior Deputy Director and State Medicaid Director

Date: November 7, 2017

Subject: Mandatory Medicaid Managed Care Network Provider Enrollment in D.C. Medicaid

The 21st Century Cures Act requires all Medicaid Managed Care network providers to enroll in State Medicaid programs by January 1, 2018. Section C.5.21.1.15 of your Managed Care contract with the Department of Health Care Finance (DHCF) also requires network provider enrollment with the D.C. Medicaid program.

Appendix A of this transmittal lists the Medicaid Managed Care network provider types that must enroll with the D.C. Medicaid program.

Appendix B of this transmittal contains a list of all providers who are currently enrolled in the D.C. Medicaid program. By November 9, 2017, please utilize this list to identify the specific providers that need to enroll in the D.C. Medicaid program. Please send this list by e-mail to Lawrence Williams (DHCF) at [email protected].

Appendix C of this transmittal contains a sample MCO Outreach letter. Please distribute the letter electronically to the network providers you identified by November 10, 2017. The outreach letter informs applicable network providers that their D.C. Medicaid applications are due by November 30,2017. The outreach letter also explains that only one D.C. Medicaid application is required even if they receive the same outreach letter from multiple Managed Care plans.

For your convenience, DHCF has also set up the following dedicated e-mail address for all inquiries pertaining to the MCO network provider enrollment process: [email protected].

1 GOVERNMENT OF THE DISTRICT OF COLUMBIA Department of Health Care Finance

Appendix A to DHCF Transmittal # 17-28

Adult Day Care Hospital, General Adult Day Health 1915(i) Hospital, LTAC Ambulance, Air Transport Hospital, Psychiatric Private Ambulance, Private Hospital, Psychiatric Public Ambulance, Public ICF/IDD Ambulatory Surgical Centers Ind Xray And Lab Audiologist Independent Lab Birthing Centers Independent X-Ray Clinic, Adlt Alc/Subst Abuse Medical Transportation Broker Clinic, Dental Clinic, Family Planning Nurse Midwives Clinic, Fed Qualified Health Nurse Practitioner Clinic, Mental Health Nursing Facility Clinic, Private Clinic, Youth Alc/Subst Abuse Optician/Optical Dispensary Day Treatment Optometrist Dental FQHC Clinic Pharmacy, Institutional Dentist Pharmacy, Retail Dentist, Group Practice Physician Assistant Doctor Of Osteopathy Physician MD Durable Medical Equipment Physician, Group Practice Early Intervention Podiatrist Hearing Aid Dealer Hemodialysis, Freestanding Radiation Therapy Center Hemodialysis, Hospital Based Rehabiliataion Center Home Health Agency Residential Treatment Center Hospice Adult Day Care Hospital, Emergency Access

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INSERT MANAGED CARE ORGANIZATION LETTERHEAD

Dear (Insert Provider Name):

Federal law requires all Medicaid Managed Care network providers to enroll with State Medicaid programs by January 1, 2018. You have received this letter because (insert name of Managed Care Organization) has identified you as a network provider serving Medicaid eligible members, who is not currently enrolled in the D.C. Medicaid program. To continue participating in the (insert name of MCO) network, your enrollment in the D.C. Medicaid program must be completed by January 1, 2018. Even if you receive this letter from multiple Medicaid Managed Care plans, you only need to submit one D.C. Medicaid enrollment application. Please note that enrollment as D.C. Medicaid provider does not obligate you to accept Medicaid fee-for-service patients.

To enroll, you will need to complete D.C. Medicaid application electronically using the D.C. Department of Health Care Finance’s (DHCF) Provider Data Management System (PDMS). You can access PDMS at https://www.dcpdms.com/Account/Login.aspx. At this website, you will also find an enrollment guide entitled How to Enroll in DC Medicaid Using the DC Provider Screening and Enrollment Web Portal, available at https://www.dcpdms.com/Documents/PDMS_HowToEnroll_User_Guide_v1.5_%207.14.201 7.pdf. Once you have logged into the PDMS website, please select the “Streamlined” application type, and then begin enrollment.

Your application must be completed in PDMS by November 30, 2017. If you have technical questions regarding PDMS, please contact the system vendor, MAXIMUS, at 1- 844-218-9700, or by e-mail at [email protected]. If you have questions about enrollment in the D.C. Medicaid Program in general, please contact the DHCF Department of Public and Private Provider Relations staff directly at (202) 698-2000.

Thank you for your attention and cooperation with this important initiative.

Sincerely,

(Insert Title and name of Managed Care Organization) GOVERNMENT OF THE DISTRICT OF COLUMBIA Department of Health Care Finance

MCO NETWORK PROVIDER ENROLLMENT IN D.C. MEDICAID FREQUENTLY ASKED QUESTIONS

I. Applicable Provider Types

Question: To what extent is the State Medicaid enrollment mandate applicable to providers by whom Medicaid reimbursable services are delivered under the administration of the Department of Behavioral Health (DBH), or the Office of the State Superintendent of Education (OSSE)?

Answer: Per Appendix A, attached to the DHCF transmittal to the MCOs dated November 7, 2017, the only providers delivering behavioral health services administered by DBH or OSSE that need to enroll in D.C. Medicaid are Mental Health Rehabilitation Service (MHRS) providers and Free Standing Mental Health Clinics (FSMHC).

Question: Are there any provider types that are excluded from the enrollment mandate?

Answer: Yes. Please refer to the list set forth in Appendix A of the DHCF Transmittal to MCOs dated November 7, 2017 for a list of all network provider types that must enroll in D.C. Medicaid.

Question: To what extent does the State Medicaid enrollment mandate apply to Vision and Dental providers?

Answer: Per Appendix A, attached to the DHCF transmittal to the MCOs dated November 7, 2017, the only providers Dental and Vision providers subject to the D.C. Medicaid enrollment mandate are: Dental FQHC Clinic, Dentist-Group Practice, Dentist, Optician/Optical Dispensary, and Optometrist.

Question: Are applicable network provider types who deliver services out-of-state also subject to the State Medicaid enrollment mandate?

Answer: Yes. There is no legal exemption for out-of-state providers. All applicable network provider types that deliver items or services to eligible D.C. Medicaid beneficiaries are required to enroll in D.C. Medicaid by January 1, 2018.

1

II. Scope and applicability of the limited 120-day period to enroll network provider pending the outcome of enrollment in D.C. Medicaid

Question: The Medicaid Managed Care regulations at 42 C.F.R. § 438.602(b)(2) state that MCOs may execute network level provider agreements pending the outcome of the D.C. Medicaid enrollment process up to 120 days. How does this 120 day “grace period” affect eligibility for Medicaid claims payment?

Answer: According to the plain language of the rule (taken in conjunction with the federal statutory mandate), the 120-day period provision applies prospectively, not retrospectively. This means that the 120-day period is inapplicable to MCO network provider agreements executed prior to January 1, 2018, the effective date of the State Medicaid enrollment requirement. After January 1, 2018, the MCOs may execute network level provider agreements with applicable provider types for up to 120 days pending the outcome of the D.C. Medicaid enrollment process. However, the MCOs must terminate such network providers immediately upon notification from DHCF that the provider cannot be enrolled, or the expiration date of the 120 day period without enrollment, and notify any affected enrollees accordingly. Encounters by applicable network provider types outside of these parameters are ineligible for Medicaid reimbursement, and are thus not considered an “encounter” for consideration in the MCOs capitation payment.

III. CMS considerations

Questions: (a) Will CMS consider a “grand-father” period for providers already in MCO network to allow claims while providers proceed through enrollment process?

(b) With an effective of January 1, 2018 and less than two months to implement, will CMS consider a grace period?

Answer: There are no exceptions to the State Medicaid enrollment deadline of January 1, 2018 for applicable MCO network providers. For considerations made by CMS during the comment period preceding publication of the Medicaid Managed Care regulations, please see 81 FR 27602.

IV. Communication between DHCF and the contracted Managed Care Organizations

Question: Will DHCF established regular meetings (weekly) with MCOs manage/track process until effective date?

Answer: Yes. DHCF will conduct weekly meetings with the MCOs through April 1, 2018. Please reference the DHCF transmittal to the MCOs dated November 7, 2017 for key deadlines in the implementation time frame.

Question: Will MCOs receive list of required enrollment provider types from DHCF? If yes, when will report be distributed?

Answer: Yes. Please refer to Appendix A of the DHCF transmittal to the MCOs, dated November 7, 2017.

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