Medicaid 201

$189.00

Get up to speed on the fundamentals of Medicaid – fast.

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Description

This course will help anyone new to the Medicaid industry get up to speed on the fundamentals quickly. Overall learning objectives of this 3-lesson course include:

  • Become familiar with the major regulations governing the program, and to know where to go to learn more about them.
  • Understand the way Medicaid is paid for, including differences in state’s use of federal funds.
  • Become familiar with CHIP programs, including how different states operate their CHIP program.

The course addresses key questions over 3 lessons.

CEU Credits: 1

Recommended pre-requisite course(s): Medicaid 101

Course Description

Medicaid is an important public health safety net program that pays for healthcare services for millions of Americans. This course builds upon the foundation lessons covered in Medicaid 101.

The course addresses key questions over 3 lessons.

CEU Credits: 1

Recommended pre-requisite course(s): Medicaid 101

What are the learning objectives?

1- Become familiar with the major regulations governing the program, and to know where to go to learn more about them.
2- Understand the way Medicaid is paid for, including differences in state’s use of federal funds.
3- Become familiar with CHIP programs, including how different states operate their CHIP program.

What does the syllabus cover?

Lesson 1- What are the major regulations for Medicaid?

Goal- For you to be aware of the major regulations governing the program, and to know where to go to learn more about them.

Key Questions Included

  1. What is the Social Security Act and how does it apply to Medicaid?
  2. What is the Code of Federal Regulations (CFR) and how does it apply to Medicaid?
  3. What other federal rules, policy or guidance govern Medicaid?
  4. What is a State Medicaid Plan?
  5. What are the Medicaid Provider Manuals?
  6. Are there other state regulations that impact Medicaid?
  7. What are the major impacts on Medicaid from the Affordable Care Act?
  8. What is the Medicaid Managed Care Rule and what is the impact on Medicaid?
  9. What is MACRA and how does it impact Medicaid?
Lesson 2: How is Medicaid financed?

Goal - For you to understand the way Medicaid is paid for, including differences in state's use of federal funds.

Key Questions Included

  1. What is the Federal Matching Assistance Percentage (FMAP)?
  2. How is FMAP calculated for each state?
  3. What is "enhanced" FMAP? What types of things can a state get enhanced FMAP for?
  4. How do states budget for their share of Medicaid costs?
  5. What are the recent trends in state Medicaid budgets?
  6. What are the steps in a state budget process related to Medicaid?
  7. What are Disproportionate Share Payments (DSH)?
  8. What are Medicaid provider taxes?
  9. What are Intergovernmental Transfers (IGTs)?
Lesson 3- What is the Children’s Health Insurance Program (CHIP)?

Goal- For you to become familiar with CHIP programs, including how different states operate their CHIP program.

Key Questions Included

  1. What FPL levels are used for CHIP eligibility in different states?
  2. What premiums are members required to pay in different CHIP programs?
  3. Can the parents of CHIP-enrolled kids get coverage through CHIP?
  4. What percentage of eligible kids are enrolled in CHIP?
  5. What are some of the common clinical challenges for CHIP programs?
  6. What are some of the financing challenges for the CHIP program?
  7. What are Medicaid Managed Care Organizations that serve CHIP members?
  8. What metrics are used to monitor performance of CHIP plans?
  9. How much do CHIP MCOs get paid?

How does this course work? What is the experience like?

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