What is a Medicaid and chip cap?
Following each measurement cycle, States included in the measurement are required to develop and submit a separate Medicaid and CHIP CAP designed to reduce improper payments in each program. CAPs are due 90 calendar days after States receive their error rate notifications.
What is cap/da?
What is CAP/DA? A Medicaid Home and Community-Based Services (HCBS) program authorized under section1915 (c) of the Social Security Act and complies with 42 CFR § 440.180, Home and Community-Based Waiver Services.
What is the Medicaid income cap for nursing home residents?
But other states impose an "income cap," which means no spend-down is allowed. In "income cap" states, a nursing home resident won't be eligible for Medicaid if the resident's income exceeds $2,313 a month (for 2019), unless the excess income above this amount is paid into a special trust, called a "Miller" trust or a "Qualified Income Trust."
How is the hospice aggregate cap calculated?
The hospice aggregate cap is calculated in a different manner for new hospices entering the Medicare program, if the hospice has not participated in the program for an entire cap year. In this situation, the initial cap calculations for newly certified hospices must cover a period of at least 12 months but less than 24 months.
What is healthcare cap?
Many states offer help to consumers with health insurance problems through Consumer Assistance Programs* (CAPs). Through a federal grant, many States have established CAPs in order to better assist consumers experiencing problems with their health insurance or seeking to learn about health coverage options.
What is a CAP report?
CAP reports are set of reports used to help our customers gain a better understanding of their healthcare and dental utilization by providing information with the goal of improving the health of their employees resulting in minimizing medical and dental costs.
What is a cap plan?
• A corrective action plan (CAP) is a step by step plan of action. that is developed to achieve targeted outcomes for resolution. of identified errors in an effort to: - Identify the most cost-effective actions that can be. implemented to correct error causes.
What is a consumer cap?
The Consumer Assistance Program's (CAP) repair assistance option offers eligible consumers whose vehicles fail a biennial Smog Check inspection financial assistance toward emissions-related repairs at a STAR test-and-repair station.
What is CAP compliance?
Overview. The Compliance Assurance Process (CAP) was developed by the Large Business and International (LB&I) Division to improve the federal tax compliance of large corporate taxpayers by employing real-time issue resolution tools and techniques.
What are the three terms designated by the cap acronym?
CAPAcronymDefinitionCAPCommunity Acquired PneumoniaCAPCapitalizationCAPCapacitorCAPCollege of American Pathologists234 more rows
What is a CAP account?
Cap Account . A separate account established and maintained by the Securities Administrator for the benefit of the Noteholders pursuant to Section 6.05.
What is a monthly spend cap?
With Spend Cap, you can choose how much you want to restrict your usage outside of your monthly data allowance. Adding a Spend Cap to your account restricts usage on certain services like roaming and MMS so you can stay in control of your bill.
What is cap corrective action plan?
Definition(s): Corrective actions for an issuer for removing or reducing deficiencies or risks identified by the Assessor during the assessment of issuer operations. The plan identifies actions that need to be performed in order to obtain or sustain authorization.
What is CAP funding?
The Consumer Assistance Program Grants (CAP Grants) provide the resources necessary to help educate and provide accurate information to consumers who are making difficult health care decisions.
What are benefits of consumer programs?
What Are the Benefits of Consumer Incentive Programs?Loyal customers. Offering money back for customers who purchase your product can create a positive association with your brand. ... Competitive advantage. ... Increased brand awareness. ... Valuable customer data.
What are the sources of consumer information?
Some of the main sources of consumer information are: Consumer reports and reviews - Opinions from other consumers, which can come from people we know or from websites, social media, and magazines. Specialized magazines usually provided reliable, unbiased reports.
When is NC Medicaid CAP/DA?
During the month of June 2019 , NC Medicaid Long-Term Services and Supports held a Community Alternatives Program for Disabled Adults (CAP/DA) Home- and Community-Based Services (HCBS) waiver orientation and educational training for CAP/DA HCBS providers.
When does the 1915 C waiver expire?
The 1915 (c) Home and Community-Based Services Waiver for the Community Alternatives Program for Disabled Adults (CAP/DA) is scheduled to expire on Sept. 30, 2018. The NC Division of Medical Assistance (DMA) must submit a waiver renewal application to the Centers for Medicare and Medicaid Services (CMS) no later than June 1, 2018, ...
When do hospices have to file a cap?
Hospices are required to file a self-determined cap no earlier than 3 months after, and no later than 5 months after the end of the hospice cap year, September 30. The earliest a hospice may file its self-determined cap is December 31, and the latest is February 28 of each year.
How long does a hospice have to be in cap year?
In this situation, the initial cap calculations for newly certified hospices must cover a period of at least 12 months but less than 24 months.
How long does it take for CGS to review self-determined cap?
Hospices will receive a letter from CGS to confirm receipt of the filed self-determined aggregate cap calculation within 45 days of receipt.
Does CGS send hospice cap reports?
Instructions are available to assist you in obtaining your PS&R reports. CGS does not send copies of PS&R reports to hospices.
Who approves CAHPS surveys?
All surveys officially designated as CAHPS surveys have been approved by the CAHPS Consortium, which is overseen by the Agency for Healthcare Research and Quality (AHRQ). CAHPS surveys follow scientific principles in survey design and development.
What is CMS survey?
The Centers for Medicare & Medicaid Services (CMS) develop, implement and administer several different patient experience surveys. These surveys ask patients (or in some cases their families) about their experiences with, and ratings of, their health care providers and plans, including hospitals, home health care agencies, doctors, and health and drug plans, among others. The surveys focus on matters that patients themselves say are important to them and for which patients are the best and/or only source of information. CMS publicly reports the results of its patient experience surveys, and some surveys affect payments to CMS providers.
Does CMS pay for quality?
Instead of only paying for the number of services provided, CMS also pays for providing high quality services. The quality of services is measured clinically, administratively, and through the use of patient experience of care surveys.
What Is Cap/Da?
- A Medicaid Home and Community-Based Services (HCBS) program authorized under section1915(c) of the Social Security Act and complies with 42 CFR § 440.180, Home and Community-Based Waiver Services. This waiver program provides a cost-effective alternative to institutionalization for a Medicaid beneficiary who is medically fragile and at risk for ins...
Who Is Eligible For Cap/Da?
- A disabled adults 18 years old and older.
- An individual who is determined to require a level of institutional care under the State Medicaid Plan.
- An individual who needs at least one or more CAP/DA home-and community-based services based on a reasonable indication of need assessment that must be coordinated by a CAP/D…
- A disabled adults 18 years old and older.
- An individual who is determined to require a level of institutional care under the State Medicaid Plan.
- An individual who needs at least one or more CAP/DA home-and community-based services based on a reasonable indication of need assessment that must be coordinated by a CAP/DA case manager.
What Home- and Community-Based Services Are Approved in The CAP/DA Waiver?
- Adult day health;
- CAP In-home aide;
- Equipment, modification and technology;
- Meal preparation and delivery;
What Is Consumer Directed Services?
- Consumer-direction is a service delivery model that allows a CAP/DA Medicaid beneficiary or designated representative to act in the role of employer of record to direct their personal care services by: 1. Freely choosing who will provide care to meet medical and functional needs; 2. Independently recruiting, hiring, supervising, and firing (when necessary) an employee (personal …
How to Make A CAP/DA Referral?
- Contact a local CAP/DA case management entity in the county of residenceof the applicant to request a CAP/DA referral. If you are a CAP/DA case management entity or a qualified home- and community-based provider, a referral can be completed in the e-CAP system. 1. Quick Facts A referral may also be made by calling 919-855-4340 or faxing the completed referral formto 919-…
Special Announcements
Covid-19 Management
- SPECIAL BULLETIN COVID-19 #55: NC Medicaid Receives Approval for Expanded Flexibilities for Home and Community-Based Services
- SPECIAL BULLETIN COVID-19 #134: Clarification of COVID-19 Temporary Rate Increases and Clinical Policy Changes
- SPECIAL BULLETIN COVID-19 #93: Targeted Rate Increase, Additional Hours and Associate…
- SPECIAL BULLETIN COVID-19 #55: NC Medicaid Receives Approval for Expanded Flexibilities for Home and Community-Based Services
- SPECIAL BULLETIN COVID-19 #134: Clarification of COVID-19 Temporary Rate Increases and Clinical Policy Changes
- SPECIAL BULLETIN COVID-19 #93: Targeted Rate Increase, Additional Hours and Associated Reporting Requirements for In-Home Personal Care Services (PCS) Providers under State Plan PCS and CAP/C and C...
Contact Information
- NC Medicaid Clinical Section Phone: 919-855-4340 Fax: 919-715-0052 Email: [email protected]