The TPL Electronic Database (TED) is an enterprise web application used to manage recovery activities for the State of Michigan Medicaid program due to Third Party Liability (TPL). As claims previously paid by Michigan Medicaid may be the responsibility of another payer, the State attempts to recover those payments. These recoveries may be obtained through a court case handled by the Legal Liability Section or through billing activities to other payers, including commercial health or pharmacy payers, by the Health Insurance Liability Section. Recoveries are received in the form of checks which are processed through the Michigan Cashiering and Receivable System (MiCaRS) system and identified as TPL related. Check information is automatically transferred to the TED system daily, where TPL staff links these checks to specific claims related to a case and / or to claims that have been billed to other payers. Money received is allocated to the appropriate Michigan Administrative Information Network (MAIN) account coding based on the original Medicaid expenditure. TED is tightly integrated with Michigan’s Medicaid Enterprise System CHAMPS. System processes and data sources originate from the State centralized Data Warehouse.
Children’s Special Health Care Services (CSHCS) is a program within the Michigan Department of Community Health (MDCH) dedicated to providing special health care needs to families of children and some adults with chronic health problems or disabilities. As part of Title V of the Federal Social Security Act and a comprehensive system of care the CSHCS program provides a wide range of coordinated health care services and care coordination to guide families to access and maintain health care for children with special needs.
KL&A was contracted by the Michigan Department of Information and Technology (MDIT) to provide Project Control Office (PCO) and Independent Verification and Validation (IV&V) for the State of Michigan Medicaid Management Information System (MMIS) replacement – Community Health Automated Medicaid Processing System (CHAMPS). The CHAMPS implementation project was the State of Michigan’s effort to replace the 30 year old legacy Medicaid processing system with a new technological, state-of-the-art system.
The Michigan Cashiering and Receivable System (MiCaRS) is a three-tier enterprise web application developed by KL&A for the Michigan Department of Community Health (MDCH), in association with the State of Michigan Department of Technology, Management and Budget (DTMB).
MiCaRS is a revenue control application that communicates with the State of Michigan’s central accounting application, the Michigan Administrative Information Network (MAIN), and that also interfaces with several MDCH systems. It provides all business functionality required to manage and control revenue in a governmental environment. The application allows users to record, correct, and report State revenue by communicating with other State applications for revenue transactions. MiCaRS allows MDCH to act as an accounting service agency, providing the ability to collect, process, and post revenue on behalf of other State of Michigan departments and agencies.
The Medicare Buy-In Program was created by Congress to assist low income Medicare beneficiaries by allowing States to assist with payment of their share of Medicare premiums. The State of Michigan is tasked monthly with validating, managing, and funding these premium payments. This monumental task involves consuming, publishing, and reconciling data with both Federal Government and State of Michigan systems including the Centers for Medicare & Medicaid Services (CMS) and Michigan’s Eligibility and Enrollment System (Bridges), Community Health Automated Medicaid Processing System (CHAMPS) and the Michigan Administrative Information Network (MAIN).
Irwin Products is a large distributor of construction equipment based in St. Louis, MO. Until recently sales people were carrying laptops into the field to enter orders on construction sites and then uploading that information when they returned to the office. In 2011 KL&A was contracted to provide a true mobile solution.
Irwin Mobile is an Apple iPad optimized order entry system. Sales people in the field are able to access current inventory information over 3G on their iPad tablets. Complete customer history and price history is available on the iPad. This up to date information allows sales people to make intelligent pricing decisions, empowering sales staff to provide customer value and increase sales volume.
KL&A was contracted by the Department of Community Health to provide Independent Verification and Validation (IV&V) for the State of Michigan’s Medicaid Compliance Program (MCP). The MCP was founded to bring Michigan’s Medicaid Service Administration (MSA) policies, systems and related processes into compliance with the Affordable Care Act (ACA).
The initiative was also chartered to expand compliant state-based Medicaid plans, specifically the Healthy Michigan Plan (HMP), a federally funded program for Michigan residents who qualify based on income and other criteria. The HMP is intended to expand the eligibility base by approximately 400,000 potential enrollees who previously had no, or limited, coverage.
KL&A was contracted by the Michigan Department of Community Health (MDCH) to provide project management and testing services for the CHAMPS HIPAA 5010 Implementation Program. Successful completion of the CHAMPS HIPAA 5010 Implementation Program provided MDCH with the ability to successfully continue day-to-day business operations with external entities using standard HIPAA 5010 compliant EDI transactions to successfully meet the federal implementation deadline.