Provider Notice issued 09/10/09

​To: Local Education Agency

Date: September 10, 2009

Re: School Based Health Services Program Update
 

The purpose of this notice is to provide local education agencies (LEAs) with up-to-date information regarding the implementation of the single statewide vendor for administrative claiming for the School Based Health Services (SBHS) Program. 
 

See critical dates at end of notice
 

In an Informational Notice dated August 13, 2009, the department notified LEAs that it had contracted with Fairbanks LLC to serve as the single statewide vendor for the SBHS Program and that the vendor would be responsible for, among other tasks, implementing a statewide random moment time study (RMTS) methodology, effective with the calendar quarter beginning October 1, 2009.  As the single vendor, Fairbanks is the only vendor authorized to conduct SBHS program duties on the department’s behalf.  The department has no contractual relation with other vendors nor are other vendors authorized to publish information, gather data or act in any manner regarding the SBHS Program on behalf of the department.  This includes, but is not limited to, distributing any proprietary or confidential information provided by Fairbanks, such as a unique userID and password, to outside entities, other than a district’s special education cooperative. 

The department sought the services of such a vendor to reduce the administrative burden LEAs bear in completing claims, and to reduce the costs LEAs incur for submitting claims for reimbursement of administrative costs incurred in support of the Illinois Medical Assistance Program.  With this vendor implementing and administering a statewide RMTS methodology, LEAs will no longer be required to have a significant number of staff participate in time studies, collect and compile time study results, or independently file administrative claims—either directly with the department or through a third-party entity.  Most importantly, this process will provide further assurance of the accuracy and validity of administrative claims.

To help offset the department's costs for administering this program, participating LEAs will be assessed 4% of all federal financial participation (FFP) earned.  Currently, pursuant to provisions in the existing intergovernmental agreements between the department and the participating LEAs, some districts are assessed as much as 10% of the total federal funding received under the SBHS program.  This proposed assessment will more equitably distribute the department's costs among the participating districts.  Furthermore, the 4% assessment will likely be much less than the fees an LEA may be assessed pursuant to the current intergovernmental agreement and/or those fees charged by a third party billing agent. 

To implement this arrangement, all participating LEAs will be required to enter into a new intergovernmental agreement with the department.  This agreement will replace any existing agreements the LEA currently has with HFS, which will be terminated effective October 1, 2009.  So that participating LEAs may claim reimbursement for October through December 2009 expenditures, the new agreement must be signed by the LEA’s authorized representative and returned to the department no later than November 30, 2009.  Failure to do so will preclude your district from claiming reimbursement for the expenditure quarter, beginning October 1, 2009.  Fairbanks will be distributing the new agreements in the coming weeks.

Effective for the time study quarter beginning October 1, 2009, the department will not accept SBHS administrative claims from any source other than the single statewide vendor (Fairbanks LLC).  Therefore, it is mandatory that LEAs wishing to participate in the SBHS Program comply with the instructions described in the August 13, 2009, letter for contacting and providing all required information to Fairbanks LLC.  Regardless of whether the LEA has yet to sign the new intergovernmental agreement, participating LEAs must provide all required information to Fairbanks, LLC.  Most importantly, they must provide the vendor with a complete listing of all potential time study participants no later than September 15, 2009.  This will ensure that LEAs' employees are included in the population of potential time study participants.

Any claims for quarters prior to the October through December 2009 quarter, including those prepared independently by your district or your billing agent, will continue to be accepted and processed by the department.  However, any such prior claims must be filed with the department by April 15, 2010.  Prior period claims received after this date will not be processed.

The department is pleased to implement the new statewide random moment time study through Fairbanks.  This new process will simplify the Medicaid claiming process, reduce your staff's time in completing claims, and increase the reliability of the claims.  To assure a smooth transition, please keep in mind these important requirements:

• Review and respond to any communication from Fairbanks and submit your time study participant list to Fairbanks by September 15, 2009
• Upon receipt of your new agreement, review, sign and return to Fairbanks by November 30, 2009

If you have any question regarding this notice or the SBHS program, please contact staff at 217-782- 3953.
 

Theresa A. Eagleson, Administrator
Division of Medical Programs