Medicaid Audits and NCCI Update: CSHA sent a letter to Gretchen Hammer at Colorado Medicaid on August 1st. The letter was shared with Christa Landis at the Medicaid Fraud Control Unit. Since that time, MFCU has stated that, based on communication received from Colorado Medicaid, it is clear fraud was not committed (any individual or business who has received communication from MFCU should obtain documentation regarding their own cases). The open cases were sent back to HCPF (Colorado Medicaid) for review and audit. CSHA has reached out to Medicaid via Jennifer Mello several times in August and have not yet received any further communication. At this point we would like to gather information for therapists on what they can expect in an audit with HCPF, what information the audit will be reviewing (i.e. documentation of services rendered vs any use of CPT codes), how we can help as a group moving forward.
Medicaid Audits and NCCI Update: CSHA Lobbyist Jennifer Mello, CSHA STAR Jenny Vail-Stencel, and members of the SLP Advocacy Group drafted a letter in response to the Department of Health Care Policy and Financing (HCPF). Read more.
Medicaid Audits and NCCI: Jennifer Mello at Brandeberry McKenna Public Affairs is working on Lobbying efforts regarding Medicaid Audits/Communication and NCCI Edits (2013-2016). She has contacted the governor's office and is working on a response from Medicaid regarding the guidance given by Medicaid employee's via email to SLP Providers since 2013. She will also contact key legislators if/when needed to address the issue. CSHA will continue to support SLPs in the state who are facing this issue with Medicaid. We urge SLPs or companies employing SLPs who were effected by these audits to please reach out to Jenny Vail-Stencel (CSHA State Advocate for Reimbursement) at firstname.lastname@example.org. CSHA urges members to stay connected while we work on this issue as a group. We will be more effective when working together. If you have had any communication with Medicaid or Legislators on this issue please let Jenny know!
Webinar of how the National Correct Coding Initiative (NCCI) edits affect billing for speech therapy in Colorado Medicaid.This webinar was provided live on March 22, 2016.
Click here to view the webinar
Click here to read the guidelines