Medicaid for FQHCs

June 14, 2021 to June 15, 2021

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.

Target Audience

  • Health Center C-Suite (CEO, COO, CFO, Compliance Officer)
  • Health Center Finance Personnel
  • Primary Care Association Personnel

Learning Objectives

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
Course summary
Available credit: 
  • 7.75 Certificate of Attendance
  • 8.00 CPE
    FTLF 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.
Course opens: 
03/25/2021
Course expires: 
12/16/2021
Event starts: 
06/14/2021 11:00am EDT
Event ends: 
06/15/2021 2:00pm EDT
Cost:
$1,799.00
FTLF Virtual Classroom
Monday, June 14, 2021 - Tuesday, June 15, 2021
*Agenda times are all ET*
 

Day 1

Monday, June 14, 2021
11:00 AM - 5:00 PM ET
11:00 am - 11:15 amIntroductions
11:15 am - 12:00 pmMedicaid as a Joint Federal/State Program
  • Sources of Law and Guidance
  • FQHCs in Medicaid
12:00 pm - 1:00 pmAn Introduction to the Medicaid PPS/Per Visit Rate
  • Construction of the Base Rate (Examination of a Medicaid Cost Report and Consideration of Allowable Costs)
  • MEI
  • Changes in Scope
1:00 pm - 1:30 pmBreak
1:30 pm - 2:30 pmAn Introduction to the Medicaid PPS/Per Visit Rate (cont.)
  • Alternative Payment Methodologies
  • Common Challenges/Areas of Litigation
2:30 pm - 2:45 pmBreak
2:45 pm - 3:45 pmFQHC Payment Protections in Managed Care
  • Comparability Requirement
  • Supplemental Payments
  • Common Challenges/Areas of Litigation
3:45 pm - 4:00 pmBreak
4:00 pm - 4:45 pmEnrollment, Overpayments, and Audits in the Medicaid Program and Typical Areas of Concern
4:45 pm  - 5:00 pmQ&A
 

Day 2

Tuesday, June 15, 2021
11:00 AM - 2:00 PM ET
11:00 am - 12:30 pmModalities and Services that Pose Challenges
  • Services to Dual Eligibles
  • Telehealth
  • Behavioral Health
  • Care Management and Patient-Centered Medical Homes
  • 340B Prescription Drug Program
12:30 pm - 12:45 pmWrap Up and Instructions for Breakout Sessions
12:45 pm - 1:00 pmBreak
1:00 pm - 2:00 pmShare Your Concerns and Discuss Your State's Payment System with Individual FTLF Attorneys (sorted by state/PCA)
  
  
  
  
  
  
  
 

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 learning@ftlf.com or 1-855-200-3822.

MATTHEW FREEDUS  

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 GHILADI

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]

TED WATERS

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.

ADDITIONAL INFORMATION

  • 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).

Available Credit

  • 7.75 Certificate of Attendance
  • 8.00 CPE
    FTLF 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.

Price

Cost:
$1,799.00
Please login or register to take this course.

Registration Fees:

Early Registration
(Through April 30)
Regular Registration
(May 1 or Later) 
$1,799$1,999

Group Discounts

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% off20% offCall us!

Registration Instructions

Each registration must be in the name of the individual(s) who will attend. This allows FTLF to communicate important course information to the actual attendee(s), add training materials and handouts to the right account, and properly assign certificates of attendance or CPE credits. 

To register for this training:

  • For yourself: login to your account and register with your personal information
  • For someone else: login with the ATTENDEE’S login information or create an account for the ATTENDEE and register from the ATTENDEE's account
  • For a group: email Learning@ftlf.com to complete group registration

If you encounter problems or have questions Contact us.


Payment

We accept payment by PayPal, credit card, and check. Payment for any live training is due upon registration. If payment is not received in full prior to the start of the event, FTLF reserves the right to cancel your order and deny you entrance to the training.

Cancellation/Transfer Policy

All cancellation or transfer requests must be received in writing at learning@ftlf.com. Requests for refunds or transfers for in-person events will be granted according to the following schedule:

  • 30 or more days prior to the event, requests for a full refund or a transfer without a fee will be granted.
  • Between 11 to 29 days prior to the event, requests for cancellations will be granted a 50% refund and requests for transfers will be granted, space permitting and subject to a transfer fee.
  • Within 10 days of the event start date, no requests for refunds or credits will be granted. At FTLF's discretion, late transfers may be granted, space permitting and subject to a transfer fee.

If there are extenuating circumstances regarding your cancellation, please reach out to the FTLF Training Team directly at learning@ftlf.com.

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