March 2015

Volume 4, Issue 2

DCH-i Masthead
 
Update on the Georgia Medicaid Paperless Initiative
 
The Georgia Department of Community Health (DCH) and DCH's fiscal agent (partner vendor) Hewlett-Packard Enterprise Services (HPES) have teamed up to transition to a paperless system for Medicaid provider enrollment, claims filing, appeals and reimbursement. The Initiative began last year with the rollout of online-only enrollment for providers.
  
As of January 1, 2015, newly enrolled Medicaid providers and institutions must enroll in Electronic Fund Transactions/Direct Deposit with their financial institutions to receive payment. On May 1, 2015, Medicaid will no longer accept paper claims submitted by either institutional or individual providers; all claims must be filed online.

Other important dates for components included in the transition to online-only are:
  • January 1, 2015 - Online-only enrollment for individual providers
  • January 1, 2015 - EFT mandate for providers
  • May 1, 2015 - The submission of ALL claims, appeals, forms, prior authorizations (PA), provider enrollment documents, DMA-520, DMA-520A and other forms must be done via the GAMMIS Web Portal.
DCH has posted an updated FAQs document with information about the Paperless Initiative. To view these FAQs, click HERE.

Contact HPES at 800-766-4456 or through the Georgia Medicaid Management Information System (GAMMIS) at www.mmis.georgia.gov.
GA Medicaid Fair set for May 6

The Department of Community Health's (DCH) Division of Medical Assistance Plans and HP Enterprise Services (HPES) will hold their semiannual Georgia Medicaid Fair on Wednesday, May 6, 2015, at the Gwinnett Convention Center. Those interested in exhibiting at the event will have an opportunity to directly interface with providers and other key Medicaid, PeachCare for Kids® and Medicaid Waiver Program stakeholders including DCH officials as well as HPES personnel. Exhibits open at 9 a.m. and close at 5:30 p.m. Exhibitors may begin set-up in Exhibit Hall B at 6 a.m. Vendors should notify Medicaid by Friday, March 31, if you intend to exhibit at this event by completing the exhibitor registration form and submitting via email to Georgia 
medicaidfair@hp.com. To download the Exhibitor Invitation and Registration Form for the Medicaid Fair, click

HERE


Georgia Medicaid Fair - May 6, 2015

6400 Sugarloaf Parkway

Duluth, GA 30097

 

Questions? Contact HP Enterprise Services at georgiamedicaidfair@hp.com.


DURB Board Seeking Nominees by May 1, 2015

 

The Georgia Department of Community Health (DCH) is seeking nominees for appointment to the Drug Utilization Review Board (DURB). The appointment will begin 

Tuesday, December 15, 2015 and service will continue for three years.  

 

The Board makes recommendations to the Department about pharmacy benefits provided to members of Georgia Medicaid. 

 

Board members' duties may include reviewing medical criteria and standards and recommending educational intervention methods and preferred drug list status. The board discusses information about drug therapy and reviews outcome assessments to identify more efficient drug utilization and cost-effective therapies while decreasing adverse events. 

 

Nominees submitting information for appointment will be considered based on their experience involving the prescribing, dispensing, teaching and monitoring of outpatient medications. All members serve at the pleasure of the DCH Commissioner. Members are reimbursed per diem for participation and compensated for parking and round-trip travel mileage.

 

Please forward information recommending nominees for appointment. You may also nominate yourself. The nomination letter should include a biographical sketch, resume or curriculum vitae with the nominee's address, telephone number and any qualifications considered professionally exceptional. Please include the nominator's contact information as well.

 

Nominations should be submitted to Gilletta Gray, R.Ph., no later than May 1, 2015, at this address:

 

                        Department of Community Health

                        Pharmacy Services - 37th Floor

                        2 Peachtree Street, N.W.

                        Atlanta, Georgia 30303-3159

 

The DURB was established under the authority of Section 1903 (3) A of the Omnibus Budget Reconciliation Act of 1990, (OBRA '90). 

 

Thank you for taking the time to assist DCH and the DURB with this endeavor. 

Wiant Named Medicaid Chief

Linda Wiant  
Dr. Linda Wiant, who has been the Pharmacy Director for DCH's Medicaid program since August 2011, has been named Chief of the Medical Assistance Plans Division effective March 16, 2015. She has spent more than 20 years in managed care pharmacy, with much of that time in Medicaid and Managed Care environments.

We'd like to introduce Linda to the provider community and welcome her to this new role!
Medicaid Provider Revalidation Deadline extended to April 1

The Georgia Department of Community Health has extended the deadline for Medicaid providers to revalidate enrollment to April 1, 2015. The Affordable Care Act mandates that states revalidate the enrollment of all providers every five (5) years.

On April 1, 2015, DCH will begin suspending providers who were sent revalidation letters and have not revalidated their enrollment. Providers have 60 days from the date of their revalidation letter to complete the revalidation process. DCH allows an additional 60 days for providers to complete the process, so those providers who have not revalidated their enrollment within the 120-day time period will be suspended from the Georgia Medicaid/PeachCare for Kids program. 

Providers who are suspended will not be paid for claims from April 1, 2015, and until such time that their revalidation has been completed (Note: Providers who do not revalidate by April 1 will be suspended for both FFS and the CMOs as well). It is very important that providers revalidate as soon as possible and not wait until the deadline date to give DCH and HPES time to process their revalidation application.

2015 Board Meeting Schedule

The Board of Community Health will meet next on Thursday April 9, 2015. To view the entire DCH Board meeting schedule for 2015, as well as actions taken at previous DCH Board meetings, click HERE.

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In This Issue
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About DCH-i  

  

DCH-i is the monthly newsletter from the Georgia Department of Community Health for all matters DCH. It provides timely and important information to you as physicians, dentists, hospitals, third-party payers, vendors, health care advocates, consumers and legislators. Our goal is to help create A Healthy Georgia -- together. Write us at

DCH-i@dch.ga.gov.

 

 

Do you have a question  
or comment? Tell us
what's on your mind at 
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About DCH

 

2 Peachtree

 

Through effective planning, purchasing and oversight, the Department of Community Health (DCH) provides access to affordable, quality health care to millions of Georgians, including some of the state's most vulnerable and underserved populations.

 

 DCH is responsible for Medicaid and PeachCare for Kids,® the State Health Benefit Plan, Healthcare Facility Regulation and Health Information Technology in Georgia.      

 

Clyde L. Reese III is the DCH Commissioner.  

 

We are dedicated to
A Healthy Georgia
.   

   

www.dch.georgia.gov 

 

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DCH-i

    

Editor-in-Chief

Jeremy Arieh

 

Circulation

Janice Abrams 

 

Director of Communications

and Legislative Affairs

Lisa Marie Shekell

 

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DCH logo in reverse 

    

DCH Mission

 

We will provide Georgians with access to affordable quality health care through effective planning, purchasing and oversight.

 

 

We are dedicated to 
        A Healthy Georgia.

      

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