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Medicaid Administrative Claiming is one avenue for sustaining and supporting a NWD System

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:

Outreach

Person-Centered Counseling

Facilitating Medicaid Eligibility

Training

Programing Planning

Quality Improvement

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.

Toolkit

Phase 1 Tools: Establish Costs and Document Medicaid Time

This work plan provides the high-level steps required for administrative claiming development, including timeframes and staff responsible for each task.

This PowerPoint presentation specifically targets engagement of state level partners, such as the Medicaid agency, State Unit on Aging, fiscal and policy staff, or other partners in the NWD System. The presentation template provides a basic outline of information the NWD lead agency could cover.

This PowerPoint presentation can be used to present an introduction for local agencies and partners that may participate in Medicaid Administrative claiming.

This tool provides a method for identifying sources of matching funds and simulates the potential FFP reimbursement.

This tool provides guidance for developing state-specific codes, including examples of approved time study codes, and guidance for developing and using a decision tree to inform accurate coding.



Phase 2 Tools: Develop Agreements and Approvals

These tools include a Cost Pool Spreadsheet, which reports on the total costs associated with each time study participant and instructions on completing the spreadsheet.

This document can serve as a template for an agreement between an operating agency and the state Medicaid agency.



Webinar Recordings and Additional Resources

March 15, 2018 Webinar - NWD Medicaid Claiming: Introduction

Have Questions? Contact Us!

NoWrongDoor@acl.hhs.gov