Medicaid claiming, also known as Federal Financial Participation (FFP), represents a way in which Federal funds are used to reimburse agencies doing work that supports Medicaid programs.
The role that NWD System’s play in assisting individuals with understanding and navigating complicated long-term services and supports includes many administrative functions that are eligible for Medicaid claiming.
Federal matching funds under Medicaid are available for costs incurred by the state for administrative activities that directly support efforts to identify and enroll potential eligibles into Medicaid and that directly support the provision of medical services covered under the state Medicaid plan, when those activities are performed either directly by the state Medicaid agency or through contract or interagency agreement by another entity. The NWD System activities that may be funded under Medicaid include:
Facilitating Medicaid Eligibility
The Centers for Medicare & Medicaid Services (CMS), in conjunction with ACL, made available on the CMS website a guidance document entitled, “No Wrong Door (NWD) System Reference Document for Medicaid Administrative Claiming.” This guidance outlines the basics of how states can draw down Medicaid administrative FFP for NWD Systems.
For further guidance, ACL has outlined the following steps across two phases of NWD System Medicaid administrative claiming development:
Each of these steps have been discussed in detail in this NWD System Medicaid Administrative Claiming Workbook.