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    Office of Long-Term Living (OLTL)

    Bureau of Coordinated and Integrated Services

    The Bureau of Fee-For-Service Programs (BFFSP) manages provider-focused activities and functions in OLTL.

    The bureau is responsible for Medicaid provider enrollment activities under provider types 03 and 59 in, coordination with the Office of Medical Assistance Programs (OMAP), and claims management in fee-for-service (FFS) programs. 

    The bureau also directs the Quality Management Efficiency Teams (QMET) that audit and analyze the quality and efficiency of services delivered by providers participating in OLTL waivers and the Community HealthChoices (CHC) Managed Care Program to ensure compliance with state and federal regulations.  

    BFFSP also manages the operations of four field offices that conduct quarterly on-site clinical and financial reviews of nursing facilities enrolled in the Medicaid program to ensure the utilization of Medicaid services and reimbursements are appropriate and consistent with regulations and prepares statistical and other reports related to the utilization of Medicaid services for senior management, consumer advocates, and other parties.

    Divisions

    This division manages the capacity of Medicaid Skilled Nursing Facility (SNF) bed complement through the participation review process. In addition, the division is responsible for FFS service planning activities in accordance with person-centered service plan requirements, monitoring home and community-based providers for compliance with federal, state, waiver, and program requirements, and conducting various reviews of SNFs’ Resource Utilization Group (RUG) II Minimum Data Set, the Omnibus Budget Reconciliation Act and billing practices. 

    The Division of Provider Operations is responsible for OLTL Medical Assistance (MA) provider enrollment activities, the OLTL Provider Helpline, claims and provider payment management for OLTL FFS programs, and the Nursing Facility Civil Monetary Penalty Reinvestment program. The Division also oversees the Financial Management Services Contract, which provides payroll assistance to participants of the self-directed model of care, the Provider Training Contract, and the Nurse Aide Training and Competency Evaluation Program Contract. 

    Contact OLTL

    OLTL Participant Helpline

    1-800-757-5042

    Enrolled OLTL participants can call the helpline with any concerns regarding their services. Hours are Monday through Friday, 9 a.m-12 p.m. and 1-3 p.m.