Electronic DMAS-122 Update

VHCA (6/20/2008)

In a recent briefing, the Department of Medical Assistance Services (DMAS) senior staff provided an update on the Department’s plans to move to an electronic DMAS-122 (formerly and more generally referred to as the MAP-122).  The completion, modification and communication of the MAP-122 form represent critical links in the overall process of Medicaid beneficiary eligibility and patient pay determination.  Historically, delays in obtaining updated MAP-122s are often tied to delays in Medicaid billing and claims processing and also play a key role in negative findings associated with Medicaid Patient Fund Account (PFA) audits.

Specifically, DMAS plans to have the electronic DMAS-122 in place by December 31, 2008.  Testing with providers and local Social Services agencies is expected to begin in late fall.  DMAS also anticipates that by June 30, 2009 the electronic DMAS-122 will be fully interfaced with Medicaid claims processing systems.  This interface should virtually eliminate the need for DMAS, through their auditing contractor Clifton Gunderson, to verify at the facility level, the existence of a DMAS-122 and should significantly reduce the scope of PFA audits and the associated burden that these audits place on nursing facilities.

DMAS is working with their contractor, First Health Services Corporation, to finalize the development plan.  Over the next two months, VHCA will work with DMAS to set up a conference call with interested providers to review the DMAS-122 automation project and its implications for nursing facilities.