Projections and Informatics


The Projections and Informatics
The  Projections and Informatics section of DHCF provides administrative support and financial services to all of DHCF’s program areas. This section is responsible for computing the fiscal impact of proposed policies, forecasting caseloads, providing analytical support to program managers and program reviews and responding to ad hoc analytical requests related to the Medical Management Information Systems (MMIS) from stakeholders within and outside of DHCF. The Projections and Informatics section provides oversight to numerous programs and activities which spend Medicaid funds and are managed by other State agencies to ensure adherence to State and federal regulations. This section also manages the Medicaid State Plan and processes regulations.  Staff members track and evaluate legislative activities which might have an impact on the activities of DHCF, both at the state and federal levels. In addition, the section oversees the policy implementation process and evaluates outcomes post-implementation.

Projections and Informatics also is responsible for the accurate and timely reporting of expenditures and revenues to the federal government and managing cash awards that support the Medicaid program. Within the regulatory compliance function, Projections and Informatics also conducts the Medicaid Eligibility Quality Control project for Kansas Medicaid and CHIP. Medicaid Eligibility Quality Control (MEQC) reviews DHCF and SRS compliance with regulations and policy governing eligibility for Medicaid benefits and how eligibility determinations are made. MEQC also is responsible for oversight of the federally mandated Payment Error Rate Measurement (PERM) project to calculate an aggregate rate of payment errors based on the accuracy of eligibility determinations and claims processing.

Four units comprise the Projections and Informatics section of DHCF.  Below is a description of each unit.

Medicaid Eligibility Quality Control
The Medicaid Eligibility Quality Control (MEQC) Unit is monitored by the Center for Medicare and Medicaid Services (CMS).  MEQC conducts focused Medicaid eligibility reviews based upon an annual project proposal approved by CMS.  MEQC is also responsible for oversight of the federally mandated Payment Error Rate Measurement (PERM) project to calculate an aggregate rate of payment errors based on the accuracy of eligibility determinations and claims processing for both Medicaid and the Children’s Health Insurance Program (CHIP).

Medicaid Policy, Coordination and Projection
The Policy, Coordination and Projection Unit (PCPU) is responsible for computing the fiscal impact of proposed policies, forecasting caseloads, providing analytical support to program managers and program reviews and responding to ad hoc analytical requests related to the MMIS from stakeholders within and outside of DHCF. The PCPU provides oversight to numerous programs and activities which spend Medicaid funds and are managed by other State agencies to ensure adherence to State and federal regulations. This unit also manages the Medicaid State Plan and processes regulations. The unit tracks and evaluates legislative activities which might have an impact on the activities of DHCF, both at the state and federal levels. In addition, the unit oversees the policy implementation process and evaluates outcomes post implementation.

Medicaid Payment and Federal Reporting
The Medicaid Payment and Federal Reporting team is charged with fiscal management and accurate financial reporting for DHCF’s programs.  Key finance activities include: managing the budget submission and adjustment processes; accurately reporting expenditures and revenues to the federal government; prudently managing cash balances and managing receipts and receivables. This team also manages all payables processing, including reconciliation of contractor pay tapes for provider payments, managing contract encumbrances and developing management reports to guide decision making.

Employee Health Plan Design and Fiscal Management

This unit serves different areas of the Division of Health Care Finance including worker's compensation, the State Employee Health Benefit Plan and Medicaid. The unit provides estimates for plan changes, external agency calculations and projections, including draft calculations for fiscal requests.  They also provide reports on membership and expenditures. The Employee Health Plan Design team serves as a liaison for SRS, the Department on Aging, the Juvenile Justice Authority. KDHE coordinating financial data for the Medicaid expenditures. The team is responsible for maintaining data and disseminating information to external and internal parties for the state employee and worker's compensation groups.