Medicaid Administrative Claiming

Agreement Administrator
OHA - Oregon Health Authority
635 Capitol St NE, Ste 350
Salem, Oregon
97301

ContactMark Bustamante (OHA)Phone1 (503) 947-5257Fax Emailm​a​r​k​.​b​u​s​t​a​m​a​n​t​e​@​s​t​a​t​e​.​o​r​.​u​s​



Agreement #
OHA-163702-20

Agreement Start Date
07/01/2020
Expiration Date
06/30/2025
Agency Number
P30950
All dates are mm/dd/yyyy


Subject Matter
Agency Key Person shall perform the work below and submit to OHA the criteria of that for OHA approval. Agency shall, for the purposes of Public Education--Based Medicaid Programs, on a monthly basis:
(a) Develop and implement on a continuing basis, a program to provide OHA and its partners with an in depth understanding of special education and IDEA, as well as, Section 504 of the Handicapped Act of 1973 under the Office for Civil Rights Department of education 34CFR104 Subpart D pertaining to children ages

3-21 years, in relation to Public Education--Based Medicaid Programs. Update the programs as needed to reflect new developments in the field. Develop written or electronic tools and presentations that will facilitate delivery of these programs to the parties involved in a timely and efficient manner;
(b) Make recommendations on the extent and nature of the training and technical assistance needs of the relevant education and Medicaid agencies/entities. Provide systematic training and technical assistance to OHA, ODE, Office of Student Learning and Partnerships Services Unit, Agency's Local Education Agencies (LEAs), and other respective education agencies, as required by these programs or providers participating in Public Education-Based Medicaid Programs and operations leveraging Medicaid;
(c) Develop, implement, and update as needed monitoring protocols, processes and documents, including self-audit tools to assist with compliance monitoring, School Medicaid Administration Claiming Manual, and cost worksheets and instructions, to be used by providers of Public Education-Based Medicaid Programs for the purpose of improving and ensuring compliance with education and Medicaid state and federal law. Provide necessary training to facilitate supplement and facilitate the implementation process;
(d) Develop Public Education-Based Medicaid Program(s) tools, and mechanisms to promote an efficient and effective working relationship between ODE, Education Service Districts, local school districts, OHA, and related entities and organizations, regarding the federal and state Public Education-Based Medicaid Programs. On a continuing basis, monitor and assess how the tools, programs and mechanisms can be modified to further achieve the goals stated in this provision;
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OHA IGA Non-County Updated: 08.03.2018
(e) Assist OHA, ODE, Office of Learning Student Services Unit, Agency's LEAs, and other respective education entities and Medicaid to develop necessary and specific policy and practice guidelines, tools and mechanisms for Public Education- Based Medicaid Programs regarding:
(i) Federal and state Medicaid and education law and practices;
(ii) Medicaid and Family Education Rights and Privacy Act (FERPA);
(iii) Medicaid and Section 504 of the Rehabilitation Act of 1973 under the Office for Civil Rights Department of Education 34 CFR104 Subpart D pertaining to children ages 3-21 years; And the Individuals with Disabilities Education Act (IDEA), including Parts B and C services (Early Intervention (EI), Early Childhood Special Education (ECSE) and Regional Services);
(iv) Teacher's Standards and Practices Certification (TSPC) and provider qualifications for Public Education-Based Medicaid Programs;
(v) Medicaid billing systems;
(vi) Business and accounting practices training and support including cost calculations, reviewing cost data, and matching requirements for Public Education-Based Medicaid Programs;
(vii) Public Education-Based Programs and reviewing and processing of quarterly random time studies for claims for Medicaid Administrative Claiming;
(viii) Provider licensure requirements for Public Education-Based Medicaid Programs, and;
(ix) Other Medicaid in education issues as required by the position and work
(f) Agency shall prepare a working document monthly for submission with the Agency quarterly invoice to OHA delineating day-to-day responsibilities/itemized deliverables for work performed under this Agreement.

Agreement Value
$850,000.00


Secondary Organization
Intermountain ESD (formerly Umatilla-Morrow ESD) (ORCPP)
2001 SW Nye
Pendleton, Oregon
97801

ContactBridget VanCleavePhone1 (541) 966-3190Fax1 (541) 966-3243Emailb​r​i​d​g​e​t​.​v​a​n​c​l​e​a​v​e​@​I​M​E​S​D​.​k​1​2​.​o​r​.​u​s​

Primary Organization
OHA - Health Systems
500 Summer Street NE, E35
Salem, Oregon
97301

ContactLinda WilliamsPhone1 (503) 945-6730Fax1 (503) 373-7689EmailL​i​n​d​a​.​J​.​W​i​l​l​i​a​m​s​@​s​t​a​t​e​.​o​r​.​u​s​


ContactLinda WilliamsPhone1 (503) 945-6730Fax1 (503) 373-7689EmailL​i​n​d​a​.​J​.​W​i​l​l​i​a​m​s​@​s​t​a​t​e​.​o​r​.​u​s​