Y2K claims processing problems. If at any time before

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					StatePlan for Title XIX                                       Attachment4.19 F

State ALASKA                                                     -L
                                                              Page

FEDERAL i'lIATCHmG OF Y2K-RELATED STATE PROJECTEDPA nlENTS TO
                                                          (SCHIP)
MEDICAID AND STATE CHILDREN'S HEALTH INSl"R..~NCEPROGR-~'v1
PROVIDERS

                       of
Given the uniqueness the Y2K problemandthe desireto avoid disruptionsof services     to
beneficiaries.while alsoensuringthe ongoingfi~':al integrity of the Medicaidand SCHIP
programs,HCFA will provide FFPin States'pa)mentsbasedon projectedproviderclaimsmade
in accordance                                 and
              with ill of the following terTIlS conditionsduring the periodJanuary1,2000
through March 31, 2000 that are a direct result ot~~   Y2K claims processing problems.

       FFP is availabletor payments                                              on
                                     madeto Medicaidand SCHIP providersbased projected
       provider claims during the periodJanuary1 through ylarch 3l, 2000 that arethe direct
       result of ~    Y2K claims processingproblems. If at any time beforeNlarch31, 2000 the
       States'sclaims processing  systembecomes Y2K compliant, FFPwil1 no longerbe
       available for any projectedpa~ents madeafter the date the State'sclaimsprocessing
       systembecomes    Y2K compliant.

2.                                                                               by
       The projectedprovider claims tor which FFPwill be availablewill be computed the
                           of
       Stateas the average the last 12monthsofpa~ents to eachprovider,or of the period
       specified in the State'sY2K Contingency Plan. For ~[anagedCareOrganizations
       (MCOs) the Statemay usethe previousmonth'5 pa~ent (i.e. December1999)...

3      Once the Statedetenninesthe average    monthly paymentto the provider.HCFA will
       allow the Stateto claim FFP tor their projectedpaymentsup to 70 percentof the average
       monthly paymenttor institutional providersand capitatedy1COs.and up to 50 percentof
       the averagemonthl:' paymenttor non-institUtional providers.

4.                                      receivablefor all pa~ents madeand for which FFP
       The Statemust establishan accounts
       was claimed basedon projectedproviderclaims.

5      \\Inen the period tor which FFPis ;lvailabletor pa}ments basedon projectedprovider
       claims ends.the Statemust incorporate   into its claims processingsysteman edit check
                                                 to
       designedto precludeduplicatepa:vments providers wherepa~ments              on
                                                                             based projected
       provider claims were madeandhavenot yet beenfully reconciled.

===============~
Effective Date -.9G_TOBER 1,       1999

Approval Date ~'4K\       , ~ I '2000
StatePlan tor Title XIX                                           Attachment 4.l9 F

State      ALASKA                                                    -2-
                                                                  Page


6.         By no later than Agril 1. 2000, for eachprovider,the Statemust begin reconciling
           paymentmadebasedon projectedproviderclaims accountS                           for
                                                                      receivablebalances the
           January1 - March 31. 2000 period against100percentof eachprovider's adjudicated
           claim amountsfor that sameperiod.andbeginrecoupingany excessive       pa)l1nentsthat
           were madeto a provider basedon projectedprovider claims amounts. All overpayments
                                                                                     or
           that were madebasedon projectedproviderclaims must be either recovered returned
                             by
           as ove'"Payments S~tember 30.2000. No F~P will be availablefor extended
                                 for
           repaymentschedules providers.

7          Before implementingthis,projectedproviderclaims pa}Tnent          the
                                                                      process, Statemust
                                                                          to
           purge itS files of all excludedprovidersto precludeany payments excludedproviders

 8         Once the Statehascompletedthe final reconciliationof all accountsreceivablebalances,
                                                                                  of
           and it hasbeenreviewedby the RO, the Statemust repol1the Federalshare any
                                        to
           outstandingStateoverpaymentS HCFA on the next Fonn HCFA-64. .~y outStanding
           overpa)mentsthat have not beenreportedon the Fonn HCFA-64 for the quarterended
                      30,
           September 2000 will be disallowed.

 9         The Stateagrees  that this policy appliesonly to pa}1nentSbasedon projectedprovider
           claims madebecause    ~ Y2K claimsprocessing        problemsprecludethe Statefrom
           processingand paying provider claims in accordance    with normal programclairo.ing
           requirements. It doesDQt   apply to pa}1nentS               of
                                                         madebecause Y2K problemswhich
                                                                 of
           precludeprovidersfrom billing the State.or because problemsnot relatedto StateY2K
           claims processing  problems. Statepa}mentS    basedon projectedproviderclaimsthat are
           not in accordance  with all of the termsandconditionsof this Stateplan amendment  will
           be disallowed.

     10.    Before implementation. the State m1.1Stsubmit to the Regional Office for approv:ll, along
            with this state plan amendment. the State's plan tor specifically implementing the tem1S
            and conditions of this State plan amendment.