Effective October 1, 2022, residential and treatment foster care (TFC) providers must begin submitting claims for the comprehensive community support (CCS) rehab per diem either to Show Me Healthy Kids (SMHK) plan, managed by Home State Health, or to MO HealthNet Division (MHD) fee-for-service, depending on the individual’s coverage. The vast majority of COA 4 participants are covered by SMHK, but children and youth who have opted out of managed care will be covered through MHD fee-for-service. Children’s Division (CD) will continue to pay room and board to residential facilities for individuals receiving services through MHD fee-for-service and for individuals receiving services through SMHK. SMHK is offering webinars on claim submission. If you would like to participate, please register for one of the training sessions and select Show Me Healthy Kids Claims Basic Training Session with a date and time that is convenient for your schedule. The training sessions can be found here: https://www.homestatehealth.com/providers/provider-training.html
Residential and TFC providers must enroll with Missouri Medicaid Audit and Compliance (MMAC) and contract with SMHK to receive reimbursement for services. While there is transition of care language in the contract with SMHK to ensure continuity of care with out of network providers through 12/31/2022, providers must still enroll/contract to continue to receive reimbursement. Further, the transition of care period does not apply to COA 4 participants that have opted out of managed care and are receiving services through MHD fee-for-service.
Please review this provider bulletin for additional information https://dss.mo.gov/rehd/providers/pdf/bulletin45-09-20220728.pdf.
If you are not yet contracted with SMHK through Home State Health, please visit https://www.homestatehealth.com/providers/join-our-network.html to request a contract. Or you may send an email to the Managed Care Contracting Team at ManagedCareContracting@centene.com, be sure to include SMHK in the subject of your email.
The MHD Education and Training Unit educate providers on proper billing methods and procedures for claim filing. Contact Education and Training at MHD.ProvTrain@dss.mo.gov or (573)751-6683. For additional resources, visit the Education and Training Resources page.
For questions about MHD enrollment, you may contact MMAC online at https://mmac.mo.gov.