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| Volume 19, Issue 2 | Winter 2008 |
Medicaid MeetingOn November 7, 2007, a meeting was held with the ND Department of Human Services, Medical Services Division at the State Capitol in Bismarck. Those attending the meeting were:
The meeting was called to discuss concerns some agencies were experiencing with Medicaid reimbursements. The purpose was to improve communications between Medicaid representatives and transit providers. This meeting was set up as an informational meeting to educate transit agencies on Medicaid. Dan Johnson, Administrator of Clinical Services, explained the basics of Medicaid. He went into the history of what Medical Services takes into account (i.e., Aging Services, Medical Services, Children Services, etc). This program began in 1969. Dan explained that the computer system that they use is extremely old, and the department is in the process of updating the system. However, the new system will probably not be available for use until 2009. The Department is also in the process of upgrading their "Plan." This Plan is expected to be completed by the first part of 2008, and is expected to clarify specific issues and procedures for all providers. Dan informed the group that there is a "Verify Line" that anyone can use to determine if the client requesting a ride is covered under Medicaid or not. This information would be extremely helpful to all transit providers. The numbers are 701-328-2891 or 800-428-4140. You can also search www.nd.gov/dhs/providers/ for additional information. Tammy Renner (Administrator & Utilization Review) and Galen Hanson (Administrator Third Party Liabilities, Surveillance Utilization Reviews, Fraud and Abuse) are both new employees to the ND Department of Human Services. Tammy passed out Medicaid Billing Code Instructions for Non-Emergency Transportation that became effective July 1, 2007. There was considerable discussion of who does and who does not receive the information sent out by the Clinical Services Department. Tammy showed concern about getting pertinent information about the working of Medicaid out to all transit projects throughout the State of North Dakota. The Medicaid billing codes for block 24D on the claims form are as follows:
Many providers are filling out the block correctly; some are not. Hopefully, this will open the door to improved communication between Medicaid administrators and transit providers. As a result of this meeting, Tammy and some of her staff plan on attending the ND state breakout at the DTA spring conference. Community Transportation Mutual Insurance Company (CTMIC) UpdateCTMIC is in the midst of the captive application process in South Carolina. CTMIC is pushing hard to get the final application approved for a conditional license and to establish CTMIC as a formal insurance company. After answering the initial questions posed by the South Carolina Department of Insurance (SCDOI), after submission of the original application, getting all related agreements signed (fronting, reinsurance, escrow, banking and service providers), making adjustments to the actuarial study, and making certain strategic changes to the operating plan, CTMIC has re-submitted the final  application for licensing and for approval of a contingent or conditional license. The contingency is collecting a minimum of approximately $1.5 million in capital and surplus from prospective members of the captive and placing the funds in an escrow account in SC. This will be collected as 30% of the first year's premium for each CTMIC member. The minimum is the required amount that the SCDOI has set, based on the CTMIC actuarial study. After the minimum is raised and deposited, CTMIC will request approval for the final license and be open for business. One strategic change to the operating plan was the creation and filing for a risk purchasing group (the Community Transportation RPG). This was done to expedite registration and use of established insurance rates in all the states by the fronting company. This is in lieu of having the fronting company file new CTMIC rates in each and every state - a very expensive and time-consuming process. The RPG has been established, and registrations in the first and second phase states are occurring now. Another strategic change that is being undertaken is designed to get CTMIC into providing insurance to CTAA members before CTMIC is formally licensed and to provide an insurance option for January 1, 2008, renewals. CTMIC is going to set up a CTAA member auto and general liability program, including physical damage coverage, with Nova insurance, the fronting company. CTMIC will be able to write insurance and issue policies based on adopted CTMIC rates through Nova Casualty Company. Nova is licensed in all states. Once CTMIC is licensed, the policies that are written under the program will be ceded (transferred) to CTMIC. In this way, CTMIC will not lose out on renewals that will occur in January or further delay prospective CTMIC members from getting insurance through the CTAA-member program. Each insured will still be required to place 30% of the premium into the CTMIC escrow account. In the event that CTMIC is not approved, the funds deposited in escrow will be returned to the committed and insured members. This approach will allow individual organizations to be insured during the review process and capitalization period at the CTMIC rates and with the proposed risk management support of CTMIC. Once CTMIC is approved with a final license (when the necessary capital and surplus is raised and in escrow [$1.5M]), all policies and funds will be transferred to CTMIC. At that point Nova, CTMIC and MaxRE will all share in the coverage and risk. What this means is that anyone in either ND or SD should be able to start getting insurance from CTMIC in early Spring 2008. 
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