Subject:
Title
Medicaid/Medicare Enrollment for Human Services Health Care for the Homeless Program.
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Recommended Action:
Recommended Action
Approval by the County Administrator for the Medicaid/Medicare Enrollment for Human Services Health Care for the Homeless Program.
• As required by the U.S. Department of Health & Human Services, health center grantees are required to establish and maintain Medicare and Medicaid enrollment applications, including the creation of the National Provider Identifier number to facilitate reimbursement from Medicare and Medicaid for services delivered by the Health Care for the Homeless Program eligible clients.
• Delegate authority to the Director of Human Services to be the identified Authorizing Official to establish, update and/or renew enrollment accounts in the Centers for Medicare and Medicaid Services, Provider Enrollment, Chain, and Ownership System, the Identity and Access Management System, National Plan & Provider Enumerations System (National Provider Identifier Application) and State of Florida Agency for Health Care Administration Provider Enrollment Portal.
• Delegate the role of Access Manager to the Health Care Administrator to report changes and updates to the enrollment record(s).
• Delegation of the Authorizing Official and Access Manager roles from the County Administrator to the Human Services Department Director and Health Care Administrator respectively, will enable the department to manage the Medicare/Medicaid enrollments as required by the federal and state government on behalf of the Health Care for the Homeless Program. Termination of the Medicaid/Medicare enrollments without cause may be made upon thirty days written notice by either party.
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Strategic Priorities:
Healthy and Safe Communities
2.1. Improve Public Health
Summary:
As required by the U.S. Department of Health & Human Services, health center grantees are required to establish and maintain Medicare and Medicaid enrollment applications, including the creation of the National Provider Identifier (NPI) number to facilitate reimbursement from Medicare and Medicaid for services delivered by the Health Care for the Homeless Program eligible clients. Delegation of the Authorizing Official and Access Manager roles from the County Administrator to the Human Services Department Director and Health Care Administrator respectively, will enable the department to manage the Medicare/Medicaid enrollments as required by the federal and state government on behalf of the Health Care for the Homeless Program. Termination of the Medicaid/Medicare enrollments without cause may be made upon thirty (30) days written notice by either party.
Background/Explanation:
The Pinellas County Health Care for the Homeless Program, is a Federally Qualified Health Center (FQHC) Program, funded in part by the U.S. Department of Health & Human Services, Health Resources Administration. By participating in the grant funded health center program, Pinellas County agreed to the terms and conditions including submission of a separate Medicare and State Medicaid enrollment application, including the creation and maintenance of a National Provider Identifier (NPI) number to facilitate the reimbursement for services through both Medicare and the State Medicaid office. Enrollment information must be revalidated every five years.
In order to establish, update and/or renew these enrollments and NPI number, Pinellas County needs to identify the Authorized Official and establish an account in the Centers for Medicare and Medicaid Services (CMS), Provider Enrollment, Chain, and Ownership System (PECOS), the Identity and Access Management (I&A) System, National Plan & Provider Enumerations System (NPPES) (National Provider Identifier (NPI) Application) and the State of Florida Agency for Healthcare Administration Provider Enrollment Portal. Per 42 CFR §424.502, the Authorized Official is the appointed official to whom the organization has granted the legal authority to enroll it in the Medicare program, to make changes or updates to the organization's status in the Medicare program, and to commit the organization to fully abide by the statutes, regulations, and program instructions of the Medicare program. For purposes of this definition only, the term “organization” means the enrolling entity as identified by its legal business name and tax identification number. The Access Manager is an individual who is delegated by the authorized official of the organization provider/supplier to report changes and updates to the enrollment record.
Fiscal Impact:
Revenue from services delivered averages under $5,000 per fiscal year.
Delegated Authority:
Authority for the County Administrator to approve these revenue generating enrollments is granted under (Code Section 2-62 (a)(1).
Staff Member Responsible:
Karen Yatchum, Director, Department
Partners:
Florida Department of Health in Pinellas County
Health Care for the Homeless Co-Applicant Board
Attachments:
Non-Institutional Provider Enrollment Form
Copy of the Online Medicaid Provider Enrollment Application