LIHP Monthly Aggregate Reporting Instructions Manual Low Income Health Program Evaluation April 2013
Version History Exhibit 1: Version History Version Date Author Updates Summary V1 February 2013 UCLA: Livy Cabezas, livier@ucla.edu Initial publication V2 April 2013 UCLA: Natasha Purington, npurington@ucla.edu Additional note added to step 5 (pg.6) and Reviewing Data (pg.13) marked as NEW V2!; Additional note added to Accessing the Monthly Aggregate Form Glossary and Definitions Exhibit 2: Acronyms and Definitions Word/Acronym Definition CMS Centers for Medicare and Medicaid Services DHCS California Department of Health Care Services LIHP Low Income Health Program MCE Medicaid Coverage Expansion HCCI Health Care Coverage Initiative STCs Special Terms and Conditions UCLA or the Center University of California Los Angeles Center for Health Policy Research FPL Federal Poverty Limit New Recipient An MCE or HCCI enrollee whose enrollment was not effective November 1, 2010 (as per the STCs) Existing Recipient An MCE or HCCI enrollee whose enrollment has been effective since November 1, 2010 (as per the STCs) Please note: new/existing recipients refer to those enrolled in the program, regardless of whether they receive services. 2
Contents Version History... 2 Glossary and Definitions... 2 Introduction... 5 Change in Reporting Methods... 5 Data Elements... 7 Navigating the Monthly Aggregate Report Form... 10 Accessing the Monthly Aggregate Form... 10 Entering Monthly Reporting Data... 12 Tips to Help You Report Successfully... 12 Reviewing and Submitting Your Data... 13 Reviewing Your Data... 13 Submitting Your Data... 14 Future Monthly Submission... 15 If You Make a Mistake... 15 Submission to DHCS... 15 Questions and Technical Assistance... 15 Monthly Aggregate Report Due Dates... 16 3
Table of Exhibits Exhibit 1: Version History... 2 Exhibit 2: Acronyms and Definitions... 2 Exhibit 3: Opening the Monthly Aggregate Form Email Attachment... 10 Exhibit 4: Downloading the Report Form... 11 Exhibit 5: Keeping the LIHP Monthly Aggregate Report... 11 Exhibit 6: Saving to Your Desktop or Local Shared Drive... 11 Exhibit 7: Submitting the Monthly Aggregate Report... 13 Exhibit 8: Entering Submitter Information... 14 Exhibit 9: Receiving the Submission Notification... 14 4
Introduction Instructions Manual for LIHP Monthly Aggregate Reports Low Income Health Program Evaluation Prepared by the UCLA Center for Health Policy Research February 2013 As part of the Low Income Health Program (LIHP), each participating county/health authority must provide Monthly Aggregate Reports to the Department of Health Care Services (DHCS), as defined in the 1115 Waiver Special Terms and Conditions (STCs). Specifically, the STCs require that each LIHP report summary statistics on the number of recipients and applicants in each month, for both Medicaid Coverage Expansion (MCE) and Health Care Coverage Initiative (HCCI) components of LIHP. The Data Elements must be reported by each LIHP for each month during which the local program was operational. This information will be used by DHCS to monitor LIHPs and conduct analysis on various operational areas in their monthly and quarterly reports to the Centers for Medicare and Medicaid Services (CMS). This document provides instructions for reporting monthly aggregate enrollment and applicant estimates using a new reporting tool. It is designed to be used as an electronic document, and has hyperlinks throughout to allow navigation within the document. Use CNTL+click to follow the links. Change in Reporting Methods The University of California, Los Angeles (UCLA) Center for Health Policy Research (The Center) has identified minor reporting issues with the previous reporting method. Mainly, LIHPs could not thoroughly review data prior to submitting, and any corrections would be manually entered and updated by UCLA staff. This reporting tool resolves these issues. LIHPs can now easily review data prior to submission and can track and update any data from previous submissions. The new tool enhances and facilitates monitoring of data submitted, while minimizing errors. This document consists of two major components: 1. Definitions of the eight Data Elements that you are asked to report monthly, as defined in the 1115 Waiver STCs. These summary statistics provide a snapshot of your enrollment and applicant figures. 2. Instructions for Navigating the Monthly Aggregate Report Form. This tool replaces the previous Reporting Portal method. The new reporting tool is an Adobe Acrobat form, where data are entered in specific fields and are then electronically submitted to UCLA. A copy of what you submit every month will reside on your desktop or local shared drive, which facilitates tracking and correcting any errors from previous submissions. 5
Summary of steps to successfully report Monthly Aggregate enrollment estimates: 1. Open and download the LIHP Monthly Aggregate Report Form from the link provided in the email from UCLA and save to your desktop or local shared drive. If your LIHP changes who submits these reports from month to month, it is highly recommended to save the LIHP Monthly Aggregate Report on a shared drive for your LIHP personnel to access. 2. Prepare your data: review the Data Elements definitions that have been defined by DHCS and CMS, based on the STCs, to understand each item reported. 3. To avoid duplicate reporting, please identify one person who will report Monthly Aggregate data for your LIHP. This person may change from month to month at your discretion. 4. For timely reporting, please adhere to the Monthly Aggregate Report Due Dates. 5. NEW V2! Save the form and if prompted, choose Overwrite existing file. Please review your data carefully and ensure there are no errors prior to submitting your data. If you have questions or need assistance regarding LIHP monthly reporting, please contact the UCLA evaluation team at chpr_lihp@em.ucla.edu. 6
Data Elements Monthly reporting data elements are required by the STCs. This reporting replaces the Monthly Aggregate reporting that was previously conducted through the Reporting Portal, via the Coverage Initiative website. For each month of program operations, you will be required to report: General Information 1) Your Contractor (LIHP) Name Select the LIHP you are reporting on from the drop down menu. 2) Your contact information Name, email address and phone number for the individual who is completing the monthly reporting. MCE Enrollment (Recipients) 3) The Federal Poverty Level (FPL) limit in your MCE program during the reporting period. This value can be any number from 1 to 133. Please note: the FPL limit can only be changed with approval from DHCS. Also, please only enter the NUMERIC value of the FPL limit for your MCE program and do not enter it as a percent. For example, if your MCE program's FPL limit is 133%, enter "133" not "133%." 4) The number of unduplicated recipients in your MCE program during the reporting period. This is a count of the unduplicated number of individuals who were enrolled in your program at any time during the reporting period in question, regardless of whether they received services. You will be prompted to report enrollment in the following two categories: a. New MCE recipients: those whose enrollment was not effective November 1, 2010. b. Existing MCE recipients: those whose enrollment has been effective since November 1, 2010. Please refer to the special considerations section for situations and circumstances pertaining to new and existing recipients that require further clarification. HCCI Enrollment (Recipients) If you had any HCCI enrollees during the reporting period, please enter data in this section. The Health Care Coverage Initiative (HCCI) is an optional component of LIHP which provides health care services to eligible non elderly adults family incomes from 133 through 200% of the FPL. If your LIHP had HCCI enrollees during the reporting period, (grandfathered from the prior program or new), please enter data in this section. If not, please skip to the LIHP Applicant Section of the report. 7
5) The Federal Poverty Level (FPL) limit in your HCCI program during the reporting period. Please note: the FPL limit can only be changed with approval from DHCS. This value can be any number from 134 to 200. Also, please only enter the NUMERIC value of the FPL limit for your MCE program and do not enter it as a percent. For example, if your MCE program's FPL limit is 200%, enter "200" not "200%." 6) The number of unduplicated recipients in your HCCI program during the reporting period This is a count of the unduplicated number of individuals who were enrolled in your program at any time during the reporting period in question, regardless of receiving services. You will be prompted to report enrollment in the following two categories: a. New HCCI recipients: those whose enrollment was not effective November 1, 2010. b. Existing HCCI recipients: those whose enrollment has been effective since November 1, 2010. If you are not a legacy county, enter the number 0 for the number of existing HCCI enrollees. Please refer to the special considerations section for situations and circumstances pertaining to new and existing recipients that require further clarification. LIHP Applicants 7) New Applicants This tabulates the total number of new applicants for the LIHP and is a count of all applicants to the LIHP program during the reporting month. Please note: sub categories a through c must add up to this total. a. MCE Applicants: Of the total number of applicants, the number that applied to the MCE program. b. HCCI Applicants: Of the total number of applicants, the number that applied to the HCCI program. If you do not accept HCCI applications enter the number 0. c. Unknown: Of the total number of applicants, the number for whom the program of application is unknown (income has not yet been verified, income will never be verified due to other ineligibility, income verification is not conducted due to enrollment cap). If you do not have any Unknowns enter the number 0. 8) Application processing during the reporting period This captures application handling activity that occurred during the reporting month. During this period, the LIHP may process newly received applications as well as those received in previous months. Report all processing that occurred. You will be prompted to enter: a. Approved: The number of applicants approved during the reporting period. b. Denied: The number of applicants denied during the reporting period. c. Pending: As of the last day of the month, the number of applicants for whom eligibility determination is pending. d. Will not be processed: As of the last day of the month, the number of applicants that will not be processed (may be due to enrollment cap or another reason to disregard the application). 8
For tips regarding submitting data elements, please refer to the Entering Monthly Reporting Data section. Special Considerations Regarding New and Existing Recipients: The following section provides clarification on unique situations that might be helpful when determining whether an individual is a new or existing recipient. Please note, the new and existing designations defined in this document are the same as the AID CODES used to classify enrollees in your program. If an existing recipient disenrolls and then reenrolls at a later date they will then be considered a new recipient at the time of their reenrollment. Existing recipients must have been continuously enrolled since November 1, 2010. If an existing enrollee has a change in income level, either an increase or decrease with a corresponding change to HCCI or MCE, the existing status would not change because the enrollee would not be disenrolled. The existing enrollee would be moved to HCCI or MCE accordingly, and would not be disenrolled unless the increase is above the HCCI FPL limit. 9
Navigating the Monthly Aggregate Report Form This next section describes how to access and utilize the form. You will need Adobe Acrobat on your computer to open the reporting tool. Accessing the Monthly Aggregate Form Open the email you received from chpr_lihp@em.ucla.edu entitled Please complete the LIHP Monthly Aggregate Report and click on the link provided to download the form. If you have previously completed this step, please skip to Entering Monthly Reporting Data. Note: Once the Monthly Aggregate Form has been downloaded and saved to your computer, you may access it from your local drive for future viewing and editing. Exhibit 3: Opening the LIHP Monthly Aggregate Form Email Attachment 10
Clicking on the link will open a tab in your internet browser to Adobe Acrobat Workspaces. There will be a download button that you will need to click on to start downloading the Monthly Report (see Exhibit 4 below). Exhibit 4: Downloading the Report Form A message may appear saying This type of file can harm your computer. Please select the Keep option. Exhibit 5: Keeping the LIHP Monthly Aggregate Report Select the PDF and save the file on your desktop or local shared drive. Exhibit 6: Saving to Your Desktop or Local Shared Drive 11
Entering Monthly Reporting Data Once you have accessed the Monthly Aggregate Report Form, please refer to Data Elements section of this instruction manual to complete the form. You will enter data in the allowable fields for the following sections: 1. MCE Recipients 2. HCCI Recipients (if applicable) 3. New Applicants 4. Applicants Processed Tips to Help You Report Successfully Be sure to enter the name of the local LIHP. Remember to enter only whole numbers in the poverty level, enrollment and application questions. Remember that the number of recipients is an unduplicated count of the number of individuals enrolled at any time during the reporting period in question. You can use Tab to move through the next field, instead of trying to navigate the form with your mouse. If you are not ready to submit the Monthly Aggregate Report and have not completed all sections, you may save the form and come back to it later. UCLA will not receive the completed form until you have clicked Submit Form. To avoid duplicate reporting, please identify one person from your LIHP to report your monthly data. This person may change from month to month at your discretion. Be sure to save your Monthly Aggregate Report often to prevent loss of data. 12
Reviewing and Submitting Your Data Reviewing Your Data NEW V2! Please review all data entered prior to submission. Once you have completely entered all data and are ready to submit your monthly report, make sure to save the report before submitting. If prompted, choose to Overwrite existing file. Click on the Submit Form button at the top right corner of your PDF (see Exhibit 7 below). Exhibit 7: Submitting the LIHP Monthly Aggregate Report You will be prompted to enter information identifying yourself, the submitter. Check the box for Remember me and click on Send (See Exhibit 8 below). 13
Exhibit 8: Entering Submitter Information Once you have entered your information and clicked Send, a message will appear within your PDF informing you that your submission was successful (Exhibit 9). Exhibit 9: Receiving the Submission Notification Submitting Your Data Once you click submit, your data will be automatically sent to UCLA. You will not receive an email confirmation that the submission was complete; this notification will appear within your completed form if submitted correctly (see Exhibit 9). Each month, UCLA will compile the data and submit the complete LIHP Monthly Aggregate Report to DHCS. 14
Future Monthly Submission For all future monthly submissions, open the saved version of your report from the previous month (on your computer) and use the Save As command so you have records of your previous and new submissions. In your newly saved version for the current reporting quarter, enter in the new data required for the current reporting period, and also correct any previously entered data with updated information if applicable. If you are updating data from a previous submission, please notify UCLA. Repeat the steps in the Reviewing and Submitting Your Data section of this report to save and submit the report for the current reporting month. Repeat the steps above to create reports for all future months. If You Make a Mistake If you make a mistake or accidentally submit data before you intended to do so, please notify UCLA by sending an email to the UCLA LIHP mailbox at chpr_lihp@em.ucla.edu. UCLA will attempt to work with you on your issue and determine if resubmitting a form is necessary. Also, please note that the new reporting tool is for the 2013 calendar year only. Any corrections to data for 2012 must be emailed to the UCLA LIHP mailbox. Submission to DHCS The Monthly Aggregate Reports are due to UCLA one month and three business days after the end of the reporting period. Please refer to the Monthly Aggregate Report Due Dates to view the specific due date for each month in the LIHP implementation period. The day after the reports are due, UCLA will export the monthly reports that have been submitted through Adobe, and will prepare them for submission to DHCS. Questions and Technical Assistance UCLA will provide technical assistance to LIHPs for monthly reporting. If you have any questions regarding monthly reporting please contact the UCLA evaluation team: chpr_lihp@em.ucla.edu. Questions in general about the requirements or the purpose of the LIHP Monthly Aggregate Reports should be directed to the DHCS LIHP mailbox: LIHPDHCS SNFD@dhcs.ca.gov. 15
Monthly Aggregate Report Due Dates The monthly reports are due at close on the third business day one month after the end of the reporting period as follows: Reporting Period Deadline to enter data into Portal July 2011 Wednesday, September 21, 2011 August 2011 Wednesday, October 5, 2011 September 2011 Thursday, November 3, 2011 October 2011 Monday, December 5, 2011 November 2011 Wednesday, January 4, 2012 December 2011 Friday, February 3, 2012 January 2012 Monday, March 5, 2012 February 2012 Wednesday, April 4, 2012 March 2012 Thursday, May 3, 2012 April 2012 Tuesday, June 5, 2012 May 2012 Wednesday, July 4, 2012 June 2012 Thursday, August 3, 2012 July 2012 Wednesday, September 5, 2012 August 2012 Wednesday, October 3, 2012 September 2012 Monday, November 5, 2012 October 2012 Wednesday, December 5, 2012 November 2012 Thursday, January 3, 2013 December 2012 Tuesday, February 5, 2013 January 2013 Tuesday, March 5, 2013 February 2013 Wednesday, April 3, 2013 March 2013 Friday, May 3, 2013 April 2013 Wednesday, June 5, 2013 May 2013 Wednesday, July 3, 2013 June 2013 Monday, August 5, 2013 July 2013 Wednesday, September 4, 2013 August 2013 Thursday, October 3, 2013 September 2013 Tuesday, November 5, 2013 October 2013 Wednesday, December 4, 2013 November 2013 Friday, January 3, 2014 December 2013 Wednesday, February 5, 2014 16