Georgia Gateway What Is It & What To Expect

Transcription

1 Medicaid Reimbursement Program Georgia Gateway What Is It & What To Expect Becky Hewitt Hall Booth Smith, P.C. Longterm Care Reimbursement Specialist

2 GEORGIA GATEWAY WHAT IS IT? Georgia s New System Used To Determine Eligibility And Maintain 6 Programs Medicaid (ABD, Peachcare, Etc.) Food Stamps Temporary Assistance For Needy Families (TANF) Special Supplemental Nutrition Program (WIC) Childcare And Parent Services (CAPS) Low Income Home Energy Assistance Program (LIHEAP)

3 GEORGIA GATEWAY Will Replace: Success - Medicaid Eligibility Determination Program Used By Caseworkers Compass Residents/Providers Use To Submit Applications And Renewals To County Offices Long Term Care Portal - Residents/Providers Use For Applications To Longterm Care Unit

4 GEORGIA GATEWAY February 2017 Pilot Program - Henry County May Wave 1 Central-western And North-western Portions Of The State (Lighter Shade) July Wave 2A All Remaining Counties Except Fulton, DeKalb, And Gwinnett September 2017 Wave 2B Entire State Including Fulton, DeKalb, And Gwinnett

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6 GEORGIA GATEWAY Upload Documents Directly To Patient s Virtual File Gateway And HP Will Interface Better Same System For Other State Agencies Such As APS, Other COA, Such As Food Stamps Programs, Driver s License Changes Will Process More Timely (IME, Transfers, Etc.) Access To Reports, Status, Notices

7 GEORGIA GATEWAY Can Only Apply Monday Friday Between 8 AM And 4 PM Will Be Sent To A Splash Page Depending On County (See Packet)

8 GEORGIA GATEWAY 2 WAYS TO LOGIN Resident/Family Login Partner/Provider Login

9 GEORGIA GATEWAY RESIDENT/FAMILY LOGIN Set Up Individual Password For Each Resident Applications Will Likely Be Forwarded To DFCS/County Case Workers Limited Amount Of Reporting Features

10 GEORGIA GATEWAY PARTNER/PROVIDER LOGIN Return Packet Of Information Received From DCH Passwords Have Not Been Issued For The May 2017 Wave Yet Expected By July Will Be Assigned On First Come First Serve Basis Applications Will Likely Be Forwarded To Long Term Care Unit Access Reports Such As Number Of Applications Provider Submits Monthly

11 GEORGIA GATEWAY OPPORTUNITY FOR IMPROVEMENT Change Can Be Challenging Renewals Increase In Denials, Client ID Not In Gateway Applications Questions That We Don t Have Answers For Caseworkers Untimely Response, Unsure Who Is Processing

12 GEORGIA GATEWAY PROACTIVE RESOLUTIONS Start At Admission Application, Gather Verifications Constant Communication With Caseworker Document All Communication Efforts Use The Chain Of Command

13 Questions? Becky Hewitt Hall Booth Smith, P.C. Longterm Care Reimbursement Specialist

14 Medicaid Reimbursement Program Georgia s Uniform Power of Attorney Act Jordan S. Johnson Hall Booth Smith, P.C.

15 GEORGIA'S UNIFORM POWER OF ATTORNEY ACT On July 1, 2017, Georgia will become the 22nd state to adopt a version of the Uniform Power of Attorney Act (UPOAA). The Act will be added into the Official Code of Georgia as Chapter 6B to Title 10. O.C.G.A. 10-6B-6(a). The UPOAA only applies to general, financial POAs that are written and created after July 1, These POAs are exclusively mandated by the new UPOAA. POAs created before July 1, 2017 are still valid and are subject to pre-july 1, 2017 Georgia law.

16 GEORGIA'S UNIFORM POWER OF ATTORNEY ACT The UPOAA does not apply to POAs that extend a power to make health care decisions. Therefore, the enactment of the UPOAA will have no effect on Advanced Directives for Health Care in Georgia. The inclusion of a healthcare decision-making provision in the documentation under the UPOAA.

17 GEORGIA'S UNIFORM POWER OF ATTORNEY ACT MAJOR CHANGES Formation/Signature The UPOAA requires the principal's signature be witnessed by a notary public, along with one or more witnesses Old law did not require a notary to be present and required two witnesses. Fiduciary Duties Explicit Statutory duties Additional protection for principals

18 GEORGIA'S UNIFORM POWER OF ATTORNEY ACT MAJOR CHANGES Petitioning the Court Allows the Principal s caregiver to petition the court to review the agent s conduct and grant appropriate relief. Revocation Revoking a POA under the UPOAA requires the principal to deliver notice to agent by certified mail and file the notice of revocation with the clerk of the superior court in the county the principal lives. Old law did not require the notice of revocation to be filed with clerk.

19 GEORGIA'S UNIFORM POWER OF ATTORNEY ACT MAJOR CHANGES HIPAA/Record Requests A person authorized by the principal in the POA to determine whether the principal is incapacitated or not, is considered a personal representative for HIPAA purposes. Inclusion of Conservatorship and Successor Agent Sections Optional provisions within the Statutory Form

20 GEORGIA'S UNIFORM POWER OF ATTORNEY ACT MAJOR CHANGES Third-Party Protection A third-party is protected when relying on and accepting a POA as long as the reliance is in good-faith and without actual knowledge that the POA is invalid. Mandatory Third-Party Acceptance Under certain circumstances, can force a third-party to accept the POA Useful in dealing with financial instructions, pension companies, etc.

21 Questions? Becky Hewitt & Jordan Johnson Hall Booth Smith, P.C.