Category: Amazing Free Content

National Average Drug Acquisition Cost Survey – The NADAC survey process focuses on retail community pharmacy drug ingredient costs. The survey collects acquisition costs for covered outpatient drugs purchased by retail community pharmacies, which include invoice purchase prices from independent and chain retail community pharmacies.

Included in the Survey of Retail Prices, in addition to a survey of the cost pharmacies incur to purchase drugs, CMS collects information on consumer prices for the purchase of drugs. This survey focuses on the collection of retail community pharmacy prices charged to consumers and the calculation of consumer unit drug prices.

Further reading –

https://www.medicaid.gov/medicaid-chip-program-information/by-topics/prescription-drugs/ful-nadac-downloads/nadacmethodology.pdf

Collaborative Application Lifecycle Tool – The CALT is a collaborative tool that creates a centralized repository for storing, collaborating on and sharing deliverables and artifacts from IT projects in support of Medicaid administration and establishment of Exchanges. CMS recently deployed the CALT on a secure cloud computing environment.

Within the CALT, CMS has created the Medicaid State Collaborative Community to allow States the opportunity to leverage, share, and collaborate on Medicaid information technology (IT) systems development projects and to submit artifacts to the CALT for review and approval as required by the systems development lifecycle (SDLC) process. CMS established CALT as a centralized platform and provides its features and functions to all users – regardless of geographic location. CALT collaboration features allow States to manage systems development activities related to planning, developing, testing, implementing, and maintaining numerous Medicaid/Exchange IT software/system applications, and to communicate their progress and innovative ideas with other States. States can also share best practices and post documents such as MITA State Self-Assessments. Through the use of CALT, CMS will provide States with timely feedback and direct support for systems development projects.

Further reading –

https://calt.cms.gov/sf/sfmain/do/home

Testing Experience and Functional Tools – In March 2014, CMS awarded TEFT grants to nine states to test quality measurement tools and demonstrate e-health in Medicaid community-based long term services and supports (CB-LTSS). The grant program, spanning four years through March 2018, is designed to field test an experience of care survey and a set of functional assessment items, demonstrate personal health records, and create a standard electronic LTSS plan.

Further reading –

https://www.medicaid.gov/medicaid/ltss/teft-program/index.html

Preadmission Screening and Resident Review (PASRR) is a federal requirement to help ensure that individuals are not inappropriately placed in nursing homes for long term care. PASRR requires that 1) all applicants to a Medicaid-certified nursing facility be evaluated for mental illness and/or intellectual disability; 2) be offered the most appropriate setting for their needs (in the community, a nursing facility, or acute care settings); and 3) receive the services they need in those settings. The PASRR Technical Assistance Center provides information in a variety of formats available from the link below, and offers free individual consultation to any state agency involved with PASRR, from simple questions to intensive on-site review and program design.

Further reading –

https://www.medicaid.gov/medicaid/ltss/institutional/pasrr/index.html

State Operations and Technical Assistance (SOTA) initiative was created to work through policy and operational changes required in Medicaid by the Affordable Care Act. In July 2015, CMS announced an enhancement to this initiative called SOTA 2.0 (PDF 212.83 KB).

The goal of SOTA 2.0 is to provide a smoother and more efficient experience for states when working across CMS on Medicaid-related issues. By creating a team that will organize itself around a state and can be accountable to them, we believe that the new SOTA 2.0 structure will provide states a more seamless experience for states as they work with CMS.

Further reading –

https://www.medicaid.gov/state-resource-center/state-operations-and-technical-assistance/index.html

Medicaid State Technical Assistance Teams – The staff in the Center for Medicaid and CHIP Services (CMCS) provides technical assistance to states on an ongoing basis on all Medicaid and CHIP topics. However, for several specific programs, CMCS has also contracted with outside entities to provide technical assistance to states on behalf of the Center.

Further reading –

https://www.medicaid.gov/state-resource-center/medicaid-state-technical-assistance/medicaid-state-technical-assistance.html

Medicare, Medicaid, and SCHIP Extension Act of 2007 – A law that extended and expanded provisions of the Social Security Act relating to Medicare, Medicaid, and the State Children’s Health Insurance Program (SCHIP). Of particular note, Section 111 of the Act addresses Medicare secondary payer issues. This section establishes the mandatory reporting to the Centers for Medicare and Medicaid Services (CMS) of all monetary compensation provided to an individual eligible for Medicare resulting from a workers compensation, general liability, or automobile no-fault claim.

Further reading –

https://www.congress.gov/110/plaws/publ173/PLAW-110publ173.pdf

The Minimum Monthly Maintenance Needs Allowance (MMMNA) is the minimum income your spouse is entitled to have each month. If his or her income falls below the MMMNA, you can transfer a portion of your income to your spouse without penalty.

Further reading –

https://www.familyassets.com/medicaid-planning/resources/monthly-needs