StatePlan for Title XIX Attachment4.19 F
State ALASKA -L
FEDERAL i'lIATCHmG OF Y2K-RELATED STATE PROJECTEDPA nlENTS TO
MEDICAID AND STATE CHILDREN'S HEALTH INSl"R..~NCEPROGR-~'v1
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.
The projectedprovider claims tor which FFPwill be availablewill be computed the
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
designedto precludeduplicatepa:vments providers wherepa~ments on
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-
6. By no later than Agril 1. 2000, for eachprovider,the Statemust begin reconciling
paymentmadebasedon projectedproviderclaims accountS for
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
that were madebasedon projectedproviderclaims must be either recovered returned
as ove'"Payments S~tember 30.2000. No F~P will be availablefor extended
7 Before implementingthis,projectedproviderclaims pa}Tnent the
purge itS files of all excludedprovidersto precludeany payments excludedproviders
8 Once the Statehascompletedthe final reconciliationof all accountsreceivablebalances,
and it hasbeenreviewedby the RO, the Statemust repol1the Federalshare any
outstandingStateoverpaymentS HCFA on the next Fonn HCFA-64. .~y outStanding
overpa)mentsthat have not beenreportedon the Fonn HCFA-64 for the quarterended
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
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
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.