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AUDIT AND RATE, RECOVERY AUDIT CONTRACTORS PROGRAM, CASE MIX SERVICES, PROMOTING INTEROPERABILITY PROGRAM AND AUDIT ACTIVITIES


Location
Hawaii
Publication Date
03/08/2019 10:19 AM EST
Closing Date
03/25/2019 08:00 PM EDT
Issuing Organization
State of Hawaii - Department of Human Services
Solicitation Number
Description

Specifications include, but are not limited to: Audit and rate reimbursement calculations of Medicaid providers, which include but are not limited to acute and long-term care facilities, federally qualified health centers (FQHC), including hospice. 2. Audits of Qualified Disproportionate Share Hospitals (DSH) and hospitals who receive uncompensated care payments (UCC) via the Medicaid Program. 3. Recovery Audit Contractors (RAC) Program to audit claims for services furnished by Medicaid providers. The Medicaid RAC’s must (1) identify overpayments; (2) recoup overpayments; and (3) identify underpayments. 4. Implement a Case-Mix reimbursement system for long-term care under the Hawaii Medicaid Program. To achieve the transition from a Prospective Payment System (PPS) based generally upon medical diagnoses to an Acuity-Based System and Case-Mix Reimbursement.

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