« Back

Connecticut to Initiate CMI Audits

January 19th, 2023 by Noreen Hiltsley


Connecticut to Initiate CMI Audits

To our valued customers:

BACKGROUND

The State of Connecticut implemented a CMI program for Medicaid reimbursement in January of 2022. Connecticut has contracted with Myers & Stauffer to perform CMI auditing for the state.

WHAT YOU NEED TO KNOW

A recent webinar by Myers & Stauffer laid out the planned system for CMI auditing:

  • All facilities will be audited yearly based on a random selection.
  • The auditor will call the facility two days in advance of the audit and verbally provide the patient audit list.
  • They will audit the greater of 20% of assessments or twenty assessments with 95% Medicaid and 5% non-Medicaid.
  • In general, the audit process takes one to two days.
  •  Audits will be completed remotely through the EMR, via screen sharing, or by uploading documents to the web portal.
  • Flagged facilities may be audited frequently.

WHAT TO DO WHEN AUDIT NOTICE RECEIVED

  • Notify your interdisciplinary team immediately and begin compiling all charts and paperwork.
  • Please include your Rehab Director and notify Barbara Blatt, Director of Appeals Management for Preferred Therapy Solutions (PTS). When contacting PTS early in the process, as your partner, we can safeguard and support your facility through the entire audit process.
  • A comprehensive and thorough review should be completed prior to submitting any of the records.

Preferred Therapy Solutions has demonstrated experience in other states utilizing a CMI-based Medicaid reimbursement system. Our processes and proven strategies provide a solid platform and expertise in the CMI audit process. We deliver the needed resources and solutions to our valued partners as Connecticut providers continue to navigate the CMI implementation and audit.

Preferred Therapy Solutions continues to provide vital information that may impact rehabilitation management, reimbursement policies, and clinical programs, supported by compliance and regulatory requirements that are necessary for a thorough understanding of practices and procedures. If you have any questions, contact Joe Menendez, Director of Clinical Reimbursement jmenendez@preftherapy.com

Posted in the categories Compliance, News.