Wednesday, October 5, 2011
Alan Maughan, New York State Department of Health Office of Health Insurance Programs
Ann Finn, Provider Consulting Solutions, Inc.
Lana MacCormack, Provider Consulting Solutions, Inc. This is a presentation of the New York State Center of Excellence for Family Planning and Reproductive Health Services for New York State family planning providers.
The transition to the Ambulatory Patient Group (or "APG") payment methodology required considerable investments in time and resources from family planning providers. Fortunately, these upfront investments will be more than outweighed by the long-term benefits of having a Medicaid payment methodology that reflects the real cost of providing quality care. Beginning in July 2011, an enhanced Medicaid payment for federally designated family planning procedures further augmented the potential reimbursements available to providers.
At the end of this presentation, participants were able to better understand APG 875 for Contraceptive Management, including the rationale for its creation and policies for its use, including special circumstances and exceptions; and recognized how the appropriate use of APG 875 will result in increased revenue. The program also provided participants with a handful of concrete examples specific to the family planning setting to which they may refer.