Fiscal Intermediary

An FMS Membership Issue Brief Summary, this issue brief presents existing fraud detection and prevention methods that directly address a selection of the recommendations offered in the 2012 report Personal Care Services: Trends, Vulnerabilities, and Recommendations for Improvement released by the Department of Health and Human Services Office of Inspector General (OIG).

The Patient Protection and Affordable Care Act (ACA) requires large employers to provide affordable healthcare coverage to full-time workers as of January 1, 2014. In preparation for the implementation of the the ACA, the NRCPDS looked into how participant direction will be impacted by the new legislation. As a consequence, in the context of participant direction, the employer mandate is likely to apply to certain Financial Management Services (FMS) providers.

View the Federal Tax Changes for Fiscal/Employer Agents in 2011, compiled by the National Resource Center for Participant-Directed Services, noting that the Advanced Earned Income Credit must no longer be paid by employers, and Federal tax deposits must be made by electronic funds transfer. Read about these changes and more.

Are you developing a participant handbook for your Veteran-Directed Home and Community Based Services program? Review state examples from Maine, Massachusetts, Texas, and Washington. These participant handbooks provide an overview of the VDHCBS program, the assessment process, developing a person-centered plan and individual budget, legal responsibilities as an employer, working with a Financial Management Services vendor, and more.

What is a Representative Payee? A person or organization who helps someone manage their Social Security money, if the beneficiary is unable to do so themselves. The state of Utah is training people to act as Representative Payees as part of their MIG grant program. This presentation outlines the differences between Rep Payees and other designations, explains roles and responsibilities and more. A sample presentation is attached below and could be helpful to other states with MIG grants.

Looking for a clear and concise summary of an existing MIG grant program? Attached is the Arizona Employment and Disability Partnership MIG Grant Fact Sheet which outlines, among other things, the programs’ goal, its approach, 2010 planned initiatives, and its AHCCCS Freedom to Work evaluation and member survey. This document could serve as a helpful guide to other states contemplating a MIG program or accessing an existing program.

Looking for an in-depth sample of MIG grant program implementation? The District of Colombia has provided their final deliverables document here. This document includes a strategic plan for Medicaid Buy-In Program Implementation, along with the subsequent step-by-step tasks, leading ultimately to the final report, and includes such tools as marketing materials, forms and brochures. This document could serve as a helpful resource to other states interested in implementing a MIG program.

This 15-page slide presentation, summarizes the need for the Medicaid Buy-In Program in Hawaii, called “Hire Abilities”. This presentation outlines the program’s goals, recent successes, need for the MIG option, enrollment, cost and more. It also looks at the national MIG picture and could be a helpful resource for other states.

An alternative to the traditional care delivery system, Arkansas’ IndependentChoices was the first program nationally that offered participant directed care as an option to its’ Medicaid population. Arkansas serves as a model for other states interested in implementing similar programs. This in depth procedures manual outlines the history, philosophy and detailed procedures for the program. Review examples of these enrollment and operating policies.

Part of the Cash & Counseling effort, IndependentChoices is a Medicaid program that allows the consumer to direct their own personal assistant services. Because Arkansas was the first state to have a program like this, their experiences and materials are a good resource for other states looking to implement similar programs. This handbook was created as an introduction for new enrollees. Also see samples of their marketing materials: Brochure, Appointment Card template and Decal.