Hello everyone,

I know this topic was discussed in the meeting today, but I wanted to reach out and see if anyone had any more details regarding Superior reducing their rates and what that will look like. Also, if anyone has any additional information on the super provider application and process.

Thank you in advance!

Quick recap

The meeting focused on billing and financial challenges faced by behavioral health providers, particularly regarding Medicaid Managed Care Organization (MCO) rate reductions and service delivery issues. The group discussed Superior 100's decision to reduce targeted case management (TCM) rates by 40% for most providers, with only three "super providers" in the entire state able to maintain existing rates, affecting approximately 178 clients. Providers shared experiences about the difficulty of predicting service needs and moving funds between service types under current contract structures, with the state expressing concerns about unanticipated shifts from residential to outpatient services. The discussion also covered challenges with billing for patient medications and medical visits, with providers typically absorbing these costs or partnering with pharmacies like Juvenile to help indigent clients. The group explored potential solutions including implementing wraparound rates to make providers whole and allowing payment of patient deductibles, co-payments, and admission fees, while…

Quick recap

The meeting focused on discussing various challenges and updates related to billing, contract management, and operational issues faced by providers. Carrie shared multiple concerns, including issues with the HHSC contract closeout for 2023, problems with uploading the security attestation form in CCMS, and a payment voucher error that resulted in duplicated claims. The group also discussed difficulties with Medicare claims, particularly regarding traditional Medicare being attached to the wrong provider type within their organization. Noelle provided an update on the ASAP website's new features, including member-exclusive groups and discussion forums to help address questions between meetings. The conversation ended with an introduction to the website's functionality and encouragement for members to use the platform for ongoing discussions and questions.

Next steps

• Carrie: Follow up with HHSC regarding the definition and reporting requirements for "program income" to ensure correct reporting in future closeouts.

• Carrie: Continue to monitor and seek…