Medicaid for FQHCs
The Medicaid program is the largest source of insurance coverage for low-income and disabled people in the country and Health Centers (both Section 330 grantees and look-alikes) play an important role in providing primary and preventive care to Medicaid-covered individuals.
This workshop is intended to convey an understanding of a health center’s enrollment and participation in the Medicaid program together with the associated rights and obligations. The workshop will assist FQHCs with understanding their Medicaid per visit rate, whether that rate is derived from a prospective payment system (“PPS”) methodology or alternative payment methodology (“APM”). Knowing how that rate is calculated and what that rate covers is important for health centers as they seek to add or modify their Medicaid-covered services. The workshop will cover significant legal protections that apply to the payment of a health center’s per visit rate under federal law.
The presenters will also cover other important aspects of the Medicaid program such as Medicaid enrollment requirements, audits and overpayments. The workshop will also address services or modalities that pose particular challenges or that are novel such as behavioral health, care management/patient-centered medical homes, telehealth, and the intersection of the 340B prescription drug program with Medicaid.
What will make this workshop unique? Because Medicaid is a joint federal-state program, there will be an opportunity at the workshop’s conclusion to break out into state-specific groups and meet with FTLF attorneys for you to share aspects of your state’s Medicaid FQHC program and payment methodology and any concerns you may have. The FTLF attorneys will run through a checklist of issues to promote a robust dialogue during these individual or small group breakout sessions. Whether you are new to the Health Center world or a seasoned veteran, these individual sessions can be used to either get up to speed or get pointed in the right direction as the case may be.
- Health Center C-Suite (CEO, COO, CFO, Compliance Officer)
- Health Center Finance Personnel
- Primary Care Association Personnel
At the conclusion of the workshop, attendees will be able to:
- Identify the special FQHC payment protections in Medicaid and articulate their rationale
- Understand how Medicaid FQHC per visit rates should be calculated under federal law
- Develop a familiarity with particular modalities or service types that may pose challenges or are novel to FQHCs in the Medicaid program
Monday, June 14, 2021
11:00 AM - 5:00 PM ET
|11:00 am - 11:15 am||Introductions|
|11:15 am - 12:00 pm||Medicaid as a Joint Federal/State Program|
|12:00 pm - 1:00 pm||An Introduction to the Medicaid PPS/Per Visit Rate|
|1:00 pm - 1:30 pm||Break|
|1:30 pm - 2:30 pm||An Introduction to the Medicaid PPS/Per Visit Rate (cont.)|
|2:30 pm - 2:45 pm||Break|
|2:45 pm - 3:45 pm||FQHC Payment Protections in Managed Care|
|3:45 pm - 4:00 pm||Break|
|4:00 pm - 4:45 pm||Enrollment, Overpayments, and Audits in the Medicaid Program and Typical Areas of Concern|
|4:45 pm - 5:00 pm||Q&A|
Tuesday, June 15, 2021
11:00 AM - 2:00 PM ET
|11:00 am - 12:30 pm||Modalities and Services that Pose Challenges|
|12:30 pm - 12:45 pm||Break|
|12:45 pm - 1:15 pm||340B Prescription Drug Program|
|1:15 pm - 1:30 pm||Wrap Up and Instructions for Breakouts|
|1:30 pm - 1:45 pm||Break|
|1:45 pm - 2:45 pm|
Breakout 1 - Share Your Concerns and Discuss Your State's Payment System with Individual FTLF Attorneys
|3:00 pm - 4:00 pm|
Breakout 2 - Share Your Concerns and Discuss Your State's Payment System with Individual FTLF Attorneys
|4:15 pm - 5:15 pm|
Breakout 3 - Share Your Concerns and Discuss Your State's Payment System with Individual FTLF Attorneys
|*If your state or territory is not listed in the breakouts above, you will be contacted by the Training Team to schedule your state or territory-specific session.|
FTLF'S VIRTUAL CLASSROOM
This live, interactive training will take place in FTLF's Virtual Classroom, hosted by Zoom. Should you have any technical questions or would like more information, please contact us at firstname.lastname@example.org or 1-855-200-3822.
A Partner with the firm, Matt represents health centers facing a variety of adverse administrative decisions and legal actions. Defending clients in all phases of administrative and judicial review, from the lowest level up to the Supreme Court, he also represents clients in affirmative litigation against states and other entities. Matt has litigated on behalf of health centers on a variety of issues, including denials of deeming applications and the scope of FTCA coverage for malpractice actions brought against health centers and their providers. [Full Bio]
Kathy is a Partner in Feldesman Tucker’s health law practice group. In the area of health law, Kathy’s practice focuses on government-sponsored health care programs such as Medicaid, CHIP, Medicare, and the Affordable Care Act, with an emphasis on payment/reimbursement and compliance related issues. Kathy also represents clients in government investigations and audits, litigation before federal and state courts, as well as in administrative appeals with the U.S. Department of Health and Human Services Departmental Appeals Board (DAB) and Provider Reimbursement Review Board (PRRB). She provides reimbursement counseling (including identification, reporting, and repayment of overpayments) with respect to Medicare, Medicaid, and private third-party payors. [Full Bio]
SUSANNAH VANCE GOPALAN
Susannah is a Partner in the firm’s health law practice group where she focuses on health care litigation and regulatory counseling, with a focus on Medicaid and Medicare payment, financing, and compliance issues. Susannah brings regulatory expertise to bear when advising clients and pursuing litigation on their behalf. She has experience negotiating Medicaid waivers and managed care arrangements on behalf of providers, provider associations, and governmental entities. She represented a group of providers in reaching a settlement in major Medicaid litigation. [Full Bio]
Serving as Managing Partner of the firm since 2003, and a member of the Health Law and Federal Grants practices since 1992, Ted is a national authority in the area of federal grants, particularly in the health and community service spheres. He advises clients on all aspects of program requirements, including issues such as cost-based reimbursement, governance and the never-ending list of grant administration matters. Ted’s expertise in financial, cost reporting, reimbursement, and administrative issues is widely recognized and he routinely handles government audits, internal investigations, and litigation. [Full Bio]
Participants can earn up to 8.0 CPE credits in Specialized Knowledge and Applications upon completion of all course requirements.
- Prerequisites: None
- Target Audience: Health Center C Suite (CEO, COO, CFO, Compliance Officer), Health Center Finance Personnel, and Primary Care Association Personnel
- Advanced Preparation: None
- Program Level: All
- Delivery Method: Group Internet Based
Feldesman Tucker Leifer Fidell LLP is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be submitted to the National Registry of CPE Sponsors through its website www.nasbaregistry.org (formerly www.learningmarket.org).
- 7.75 Certificate of Attendance
(Through April 30)
(May 1 or Later)
Bring your team! Discounts are available for groups of three (3) or more individuals from the same organization. Please contact us to process your registration.
Groups of 3 - 6
Groups of 7 - 10
Groups of 11 - 15
Over 15 attendees
|10% off||15% off||20% off||Call us!|
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- 30 or more days prior to the event, requests for a full refund or a transfer without a fee will be granted.
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