Wednesday, November 19, 2014

Reimbursement Resources Available to AHCA/NCAL Members

Abigail Horn

The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) provides many resources for members to help navigate a variety of Medicare and Medicaid issues. Visit the AHCA/NCAL website to check out these available toolkits:

· Medicaid Long Term Services and Supports (MLTSS) Toolkit – This toolkit is based on guiding principles that AHCA believes must be part of any Medicaid MLTSS program. It includes suggestions for statutory, regulatory or contractual agreement language, as well as a checklist of points to review in MLTSS plan contracts.

 · Medicare Advantage Toolkit – This toolkit consists of three modules designed to guide providers through the basics of the Medicare Advantage program and strategies for contracting between providers and plans. The first module provides an overview of the MA program, while the second module does a deep-dive in how plans are reimbursed by the government and how they, in turn, reimburse providers. The final module is a model contract with a discussion of necessary provisions you should be aware of before entering negotiations.

 · Accountable Care Organization Toolkit – This toolkit was developed for providers who are considering entering into contractual relationships with one or more of Medicare’s Accountable Care Organizations (ACOs). The guide is divided into three parts: a primer on the ACO program, a robust discussion to help providers prepare for and negotiate with ACOs and a model contract with discussion around discrete provisions providers should consider when negotiating with ACOs.

· State of the States Clearinghouse – This toolkit provides members with access to key Medicaid and Medicare information. The Clearinghouse is a one stop shop for valuable state-specific data impacting the long term care profession. View this short webinar to learn more about this tool.

AHCA/NCAL will continue to provide new resources in 2015 focused on the issues that matter to our members, such as Fraud and Abuse, MLTSS Contracting and more. Look for more updates to come in the New Year!

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