Medical Assistance PEAK and CCUG projects 1 For all March 2016 Build projects please visit TrainColoradocom for more information Courses gt CBMS Build Training gt March 2016 gt ID: 796783
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Slide1
Spring into action!
SDC Spring BuildMedical Assistance, PEAK, and CCUG projects
1
Slide2For all
March 2016
Build projects, please visit TrainColorado.com for more information.
Courses > CBMS Build Training >
March 2016 > March 2016 CBMS Build document
2
Slide3MA retro close/10-day noticing exceptions update
8601
Slide4Project 8601
Updates MA termination noticing functionality in CBMS to current policy
Slide5Change 1
Cases will close at the end of the month the change was authorized, rather than the month the change occurred, for:Not in the home
Not
requesting assistance
Whereabouts unknownNot a Colorado resident
Slide6Change 1
10 day noticing does not apply to these casesChanges authorized the last day of the month will close the case the last day of the following month
March 31
st
closures are effective April 30th
Slide7Change 1
CBMS will not retro-close for:Not in the homeNot requesting assistanceWhereabouts unknownNot a Colorado resident
Slide8Scenario 1
Household moved out of state on 07/15/2015 The move was discovered on 2/22/2016
Change Authorized
2/22/2016
Slide9Scenario 1
MA Case closes 2/29/2016 (residency)Med Spans end 2/29/2016
Slide10Scenario 2
Person A in a 3-person case leaves the home on 03/27/2016Change is authorized 03/27/2016
Slide11Scenario 2
Person A’s termination date 03/31/2016 Person A’s Med Span Ends 03/31/2016
The rest of the household is re-evaluated for
eligibility
10 day noticing would apply to them.
Slide12Change 2
MA coverage will terminate the actual date of change for:DeathIncarceration
Slide13Change 2
10 day noticing does not applyMed Spans close the actual date of change, even in past months
Slide14Scenario 1
Client passes away on 01/15/2016 Change is authorized 3/29/2016
Slide15Scenario 1
MA case closes 01/15/2016 (death)Med Span ends 01/15/2016 Retro close is applied
Slide16Scenario 2
Person B in a 4-person household dies on 02/26/2016 Change is authorized 2/29/2016
Slide17Scenario 2
Person B’s termination date 02/26/2016 Person B’s Med Span ends 02/26/2016
The rest of the household is re-evaluated for
eligibility
10 day noticing would apply to them.
Slide1818
Questions?
Slide19MA Appeals Updates
8605
Slide208605
CBMS will override closures for continuing benefits related to pending appeals and appeal decisions
Slide218605
Adds to existing MA appeals page in CBMSRead only for eligibility sitesImproved continuing coverage documentationSpeed letter noticing when continuing
c
overage is approved
Slide2222
Questions?
Slide23Build 8991
MAGI Updates
23
Slide2424
Income For Ministers
Housing Allowance
F
or Ministers
In-Kind Income For Ministers
Newly added CBMS Fields
Newly added PEAK Fields
Slide2525
Reminder
Earned Income is considered compensation from a
business including
wages, salary, tips, commissions and bonuses.
Self-Employment income is when an individual works for himself or herself instead of working for an employer who pays a salary or a wage.
Slide2626
The Employment History page has a newly added value for “
MINISTER
” under the occupation tab
.
A
dditi
onal
fields will
open when Minister is selected.
Slide2727
Example
As
a minster
the
income would
not
be considered income from wages, salary, and
tips. It
would be considered
self-employment income.
Remember to select Minister as the occupation in the Employment History page.
Slide2828
Income For Ministers
Housing Allowance
F
or Ministers
In-Kind Income For Ministers
Newly added CBMS Fields
Newly added PEAK Fields
Slide2929
Once
“
MINISTER
” is selected as the occupation for the Member
a
NEW
Housing Allowance for Minister
field, will become enabled in the Income Received
Page.
This field will capture the Housing Allowance for the Minister.
The
Housing Allowance for Minister
Compensation will be excluded as income for MAGI
calculation.
Slide3030
Example:
Self-Employed v. Employee
Self-Employed Minister
- If
you have a minister who is self employed, the minister will not receive a housing allowance.
Employed Minister-
If
you have a minister who is an employee, the minister
could
receive a housing allowance.
Slide3131
Income For Ministers
Housing Allowance
F
or Ministers
In-Kind Income For Ministers
Newly added CBMS Fields
Newly added PEAK Fields
Slide3232
When Minister
is selected in the Employment History page as the
Occupation
this new field will become enabled in the In-Kind Income page. “Is this income for Minister Compensation”? Yes or No
In-Kind
Income page
Slide3333
Income For Ministers
Housing Allowance
F
or Ministers
In-Kind Income For Ministers
Newly added CBMS Fields
Newly added PEAK Fields
Slide3434
A
nnualized Earned Income
The housing allowance payment will be excluded from the Annualized
E
arned Income and from the In-Kind Income MAGI calculation for Minister’s Compensation
Slide3535
Excluded Income
for
MAGI
Both
SSA Title II Payment and Railroad Retirement
are
exempt
IF
the individual is a Tax Dependent AND not required to file taxes regardless of age.
Slide3636
The
Home Care Allowance Payment
is exempt for Non-MAGI and MAGI
if
the individual
is identified
as “In The Home.”
Excluded Income
for
MAGI
Slide3737
Non-MAGI
-
Minister Compensation
including
the portion that is not Housing Allowance will be considered income for Non-MAGI programs.
Slide3838
Capital Payments from Tribe such as:
Natural Resources
Usage Rights
LeasesRoyaltiesPayments from Natural Resources such as:FarmingRanching
Fishing
Leases
Royalties
Excluded Tribal Income for Non-MAGI and MAGI
Slide3939
Rental
Income
-
Non-MAGI requires verification of rental income EDBC will pend the Non-MAGI member who has rental incomeThe member will be given 10+5 business days to provide the verificationThe member will be discontinued if the verification has not been received
Non-MAGI Updates
Slide4040
Income For Ministers
Housing Allowance
F
or Ministers
In-Kind Income For Ministers
Newly added CBMS Fields
Newly added PEAK Fields
Slide4141
PEAK
Updates
A Member applying via PEAK will now be asked whether the earned income is
Minister Compensation
.
If the member answers
YES
, the member will be required to answer
the question
W
hat
portion is used for Housing
Allowance
.
Slide4242
PEAK
Member’s will
receive
Gross Pay Instructions
This will help clarify most questions about Gross Pay.
Slide4343
PEAK will display the annualized income
without
any deductions
Slide4444
PEAK Updates for American Indian or Alaska Native
PEAK will display these NEW fields when American Indian or Alaska Native is selected as a race or when the member selects they are a member of a Federally Recognized Tribe.
Slide4545
Questions?
Slide46CCUG
46
Slide47Project 8850
47
CCUG
ACP Special Indicator
Slide4848
Project 8850
Project 8850 will allow CBMS to accurately identify Address Confidentiality Program (ACP) status
.
The Case Special Indicators page will have a new Type of Special Indicator, “ACP”, and a new verification Source, “ACP Documents.”
Slide4949
ACP Background
The Colorado Address Confidentiality Program provides survivors of domestic violence, sexual offenses or stalking/harassment with a way to shield them from being located through public records.
ACP participants are provided with the ACP address and an individual apartment number to receive mail; mail received is forwarded
to the ACP participant’s actual address. A maximum of two employees per eligibility site have access to ACP cases to comply with privacy requirements.
Please
view the
Colorado Address Confidentiality Program Web Based Training
located
through
the SDC
website, TrainColorado.com, for
more information about
ACP.
ACP
1001 East 62nd Ave.
Apartment Number
Denver CO
80216
Slide5050
The new ACP indicator
will allow
CBMS users
to accurately identify ACP clients in CBMS. Previously there was no ACP choice and the case Type was inaccurately labeled “Employee Recipient” or “Employee Related”.
Slide5151
CBMS Changes
In the Case Special Indicators page:
Type of Special Indicator
is “ACP”Verification Source is “ACP Documents”Note: The “ACP Documents” Verification Source shows only when “ACP” has been selected as the Special Indicator.
Slide5252
Entering the ACP Address in CBMS
Additionally,
after identifying the ACP client* using the approved procedure outlined in the ACP WBT you
must enter: Mailing AddressHome address Apartment NumberCurrent ACP address:1001 East 62nd Ave.
Apartment Number
Denver CO
80216
*All ACP clients have an
ACP card and County of Residency letter.
Slide5353
Where do ACP Participants Apply for Benefits?
Although the ACP address is located in Adams County, applicants that
are part of
the ACP program apply in the county where they reside. ACP clients DO NOT apply in Adams County unless they actually live there.
Example
:
ACP
client
living
in El Paso County
correctly applies
for benefits in El Paso County, even though the ACP address is Adams County
.
Slide5454
Links to
ACP
information listed below are located in the
March 2016 Build Document*
ACP
Brochure
ACP Website
HCPF Agency Letter
CDHS Agency Letter
*
SDC website: TrainColorado.com/Documents and Resources/Document Library/ CBMS/March 2016 Build
More ACP Information
Slide5555
Questions?
Slide56PEAK Projects
56
Slide57Project 8995
57
HCPF
Update Effective Begin Date Mapping for RMC
Slide5858
Project 8995
PEAK Report My
Changes (RMC)
will be updated to send the correct Effective Begin Dates to CBMS when a PEAK user submits a change via RMC. This project will accurately map the dates from PEAK to CBMS and ensure accurate eligibility determination. There is no policy change.
Slide5959
CBMS Pages Affected
Effective Begin Dates will be correctly mapped to CBMS for following information:
Billing and Payment Records
Burial Asset information Child/Spousal IncomeColorado Residency
Dependent
Care
Expenses
Disability
Determination
Disposing of a resource
Employment History information
Financial Aid
Health
Care
Coverage
Household Relationships
Income Expenses
In-Kind Income
Insured Individuals
Language
Life Insurance information
Liquid Asset information
LTC
institution
information
Medical Conditions
Medical Expenses
Medicare Expenses
Medicare Part D Expenses
Phone Number
Real Property
Rental Income
Room and Board Income
Shelter Billing Expenses
Shelter Expense
Shelter Payment
Student Details
Unearned Income
Vehicle Details
Voluntary Striker Information
PEAK
Pro
LTC
Level of Care
Slide6060
What are the Correct Effective Begin Dates?
For information on accurate Effective Begin Dates please reference Online Help in CBMS.
Slide6161
Questions?
Slide62Project 9266
62
Food Assistance
Updates to PEAK Inbox Mapping
Slide6363
What is it?
When a Change Report is entered into PEAK and contains an application for any new HLPG, it will now appear in the CBMS PEAK Inbox Search page as a initial application.
The
Application Type field and the
App Type
column will display the new type:
“Change Reports-New Application
”.
Slide6464
Why is this useful?
This
change
will allow CBMS PEAK Inbox users to immediately identify a Change Report that contains a new application for any HLPG. In turn, it will help CBMS users to meet timely processing standards.
Slide6565
Questions?
Slide66Project 9270
66
HCPF
PEAK
Pro
Security Changes
Slide6767
What is it?
Please note that while this project enhances current functionality in
PEAK
Pro for Community Based Organizations (CBOs), a pilot program will be implemented in order to phase in the CBO process. With this project, the PEAKPro module update will allow CBOs to assist clients with:
creating accounts
starting and submitting applications
reporting changes on existing cases
This functionality will be available for PEAK Accounts
with Medical
Assistance (MA) only and applications for MA only. If
another
non-MA program is
added,
the CBO access is revoked automatically.
Slide6868
Questions?
Slide69Project 9313
69
HCPF
PEAK
Pro
System and Reporting Changes
Slide7070
Department of Corrections Inmate Number field
A Department of Corrections Inmate Number field will be added to
PEAK
Pro for Department of Corrections (DOC) PEAKPro users so they can locate a record in PEAKPro by inmate number. CBMS users will see a new informational only field, DOC Inmate Number
in the
Conviction Parole Rehab page.
Slide7171
As an extension of previously deployed Project 7363,
Single
Entry Point (SEP)
PEAKPro users will now be able to submit Level of Care (LOC) determinations for non-PEAK applicants [individuals who did not originally use the PEAK Apply For Benefits (AFB), Report My Changes (RMC), or RRR application].When LOC Assessment Results are submitted by SEP users for a non-PEAK applicant, the results will be sent to CBMS.
SEP
PEAK
Pro
Users, LOC Determinations, and
Non-PEAK Applicants
Slide7272
What will the results be?
1. Existing
case in CBMS and
SEP submits an LOC Assessment via PEAK with the values in green below: Assessment results will be submitted as Change Report and uploaded automatically to CBMS with Real Time Eligibility (RTE).
2. All
other
LOC decisions:
Sent
to
PEAK
Inbox
as
Change Reports to be
processed manually by
the CBMS user.
Values that support RTE
LOC
: Undetermined
Decision
: Pending
Verification
: Received
Source
:
Self-Declared
Slide7373
Other
PEAK
Pro
changes All PEAKPro users can:upload documents to a specific case for all HLPGs see
all previously uploaded documents
PEAK
Pro
users may generate the following monthly reports in
PEAK
Pro
showing application status, determination and type:
PEAK
Pro
DOC Monthly Report
PEAK
Pro
CBO Monthly Report
PEAK
Pro
SEP Monthly Report
PEAK
Pro
security administrators at Agency and Program Area level may switch between inboxes within their organizational branch.
Example 1
: DOC administrator will be able to see different
DOC
PEAK
Pro
IDs
; they will not be able to see SEP or CBO inboxes.
Example
2
: HCPF Administrator will be able to toggle between
all
PEAK
Pro
inboxes
within the HCPF branch (SEP, DOC,
CBO)
Slide7474
Questions?
Slide75Project 9341
75
Food Assistance
Default to US Mail when E-Notification is Unavailable in PEAK
Slide7676
Paper Notifications
This project will ensure that if the electronic correspondence (text or email) fails because of a service interruption, paper notifications will be automatically triggered so the household receives their correspondence timely.
Note: When service is restored after a service interruption, the client will resume receiving
E
notifications.
Slide7777
Questions?
Slide78Project 9342
78
HCPF
PEAK Medical Cards Request Updates
Slide7979
What’s Changed?
The
PEAK Medical Card Request
process has been updated, and the card has been redesigned and renamed the Health First Colorado card. The Health First Colorado card request process in PEAK will be more user-friendly and reduce requests for mailed cards.Request process updates to PEAK:Printing a card more prominentCard requests may be made for more than one person at a timeAll individuals’ cards display in single PDF when user clicks on
View/Print Card
Request Reason
field removed from PEAK and becomes optional in CBMS
Slide8080
Health First Colorado Card - English
The Health First Colorado card will contain the new Health First Colorado
logo
to introduce the rebranding of the Colorado Medicaid Program.
Slide8181
The second page contains the same information printed in Spanish.
Health First Colorado Card - Spanish
Slide8282
All new cards printed through PEAK
after
the March 2016 build will have the Health First Colorado logo
.
Mailed cards will continue to sport the old logo till the June 2016 build, when the rebranding will be fully implemented.
Implementation
Slide8383
Questions?
Slide84Project 9583
84
HCPF
PEAK Update MA Application
(Add EPDST and Auth. Org.
Slide8585
PEAK Apply for Benefits (AFB) will now contain screening questions for special services, EPSDT (Early and Periodic Screening Diagnostic and Treatment) and Healthy Communities. This will align PEAK with the paper application, which already asks the questions.
The questions will only appear if there are household members who meet
the following criteria when applying for benefits:Requesting Medical AssistanceUnder 21 years of agePregnant
New PEAK Screening Questions
Slide8686
The questions will appear in a special section on the PEAK application PDF.
The PEAK Inbox will have an indicator when these questions have been answered and appear on the
PDF. You
will still fax the information to Healthy Communities, continuing with the current process for paper applications with the screening questions completed.
PEAK PDF
Slide8787
Another part of the project is that applicants may
choose an organization as their Authorized Representative for PEAK Medical Assistance applications.
Changes to the CBMS Authorized Representative
page:Unknown Individual field renamed Unknown Individual/Authorized Organization Organization text field added
Authorized Organization
Slide8888
For MA-only applications the applicant can choose an Authorized Representative (Individual) OR Authorized Organization.
Note: As is currently in place for CDHS programs, including MA-combo applications, more than one Authorized Representative (Individual) AND an Authorized Organization may be selected for the case.
How Many?
Slide8989
Questions?
Slide90CBMS
90
Slide91Project 9242
91
CBMS
SVES Interface Request and Response Changes
Slide9292
Implementation of project 9242 will begin receipt and posting of SVES data for National Prisoner Match and 40 Qualifying Quarters into CBMS to be in compliance with the SSA requirements for SVES.
Those eligibility
workers
who pull this information will no longer have to access the SVES Mainframe to request and receive said information.New SVES Data Posting to CBMS
Slide9393
New columns
on the Summary
record:
Status Code Status
View SVES NPM Data Page-New Fields
Slide9494
New
Request for
Information
button will print the Request for Information letter at the eligibility site for mailing to the client.The request will trigger one of two letters:18 years of age or older at time of confinement: Request for Information for Facility Name Under 18 years of age at time of confinement: Request for Information for Case Name for individual from the parent/caretaker guardian
View SVES NPM Data Page-New Button
Slide9595
Changes to the View SVES 40 Quarters Data page:
New fields on the Summary record:
Condition Code
and Condition DescriptionCBMS now sums all quarter data received from SSA and posts the data in the Detail record. SSA data will be listed by year; quarter-type income will no longer be populated.
View SVES 40 Quarters Data Page
Slide9696
SVES Request Page
Changes to the SVES Request page:
County
and IM14 Sign Date fields removedCBMS will generate the IAR request from Benefit Issuance. Eligibility workers no longer need to manually enter an IAR request on the SVES Request page.
Slide9797
Questions?
Slide98For all
March 2016
Build projects, please visit TrainColorado.com for more information.
Courses > CBMS Build Training >
March 2016 > March 2016 CBMS Build document
98