October 2021 |  Vol. 7   No. 4

Deputy Director's Corner

What is MMAC?  

You can find MMAC at mmac.mo.gov.  It is Missouri Medicaid Audit and Compliance.  They are a DSS support division that reports directly to the Director’s Office.

MMAC is relatively new, compared to Missouri’s Medicaid program overall.  Every state Medicaid agency is required to have a Program Integrity Unit.  They must do post-payment reviews and preliminary investigations regarding provider fraud, waste, and abuse.  Before MMAC, the PI Unit was at MO HealthNet, called the SURS unit.  Provider enrollment was also at MHD.

Now, the MMAC team is over at the Jefferson Building (except some investigators are over at Knipp).  The MMAC team does provider enrollment, provider audits, provider investigations, and provider sanctions.  They refer fraud cases to the Medicaid Fraud Control Unit at the Attorney General’s Office.  MMAC also does the vetting (contract process) with certain home and community-based providers like those providing Consumer Directed Services or state plan personal care services.

MMAC is not responsible for investigating participant fraud.  Our Division of Legal Services handles that.

However, MMAC does have a participant Lock-In until.  This team reviews reports to identify participants who have multiple doctors, pharmacies, and prescriptions, and who may be “doctor shopping” to receive multiple medications.  They may “lock-in” a participant to one primary care doctor, and/or one pharmacy.

Sometimes the MHD team receives a concern from a provider, or one of the provider’s colleagues, employees, or ex-employees.  If the concern is fraudulent or wasteful billing, or some other type of MHD program violation, we send these to MMAC.  MMAC and MHD will work together to share any necessary program information. 

Where do you find MHD program violations?  You can find the regulation by Googling Missouri Code of State Regulations.  We are Title 13.  

sos.mo.gov/adrules/csr/current/13csr/13csr

Then you choose division 70, and chapter 3.  Then you look at 13 CSR 70-3.030.  This lists all the program violations as well as provider requirements.  If you look at division 65, you will see some MMAC rules.

MMAC works closely with MHD, DHSS, DMH, providers and provider associations, and the AGO.  If you have any questions, let me know, and now you know where to send those concerns about fraud, waste, and abuse!

Jessie

• October is National Disability Employment Awareness Month. This observance was launched in 1945 when Congress declared the first week in October as “National Employ the Physically Handicapped Week.” In 1998, the week was extended to a month and renamed. The annual event draws attention to employment barriers that still need to be addressed.
• October is LGBT History Month, a U.S. observance started in 1994 to recognize lesbian, gay, bisexual and transgender history and the history of the gay-rights movement.
• October is Global Diversity Awareness Month, a month to celebrate and increase awareness about the diversity of cultures and ethnicities and the positive impact diversity can have on society.

Staff News

These MHD folks recently attended a Poverty Simulator that was hosted by Central Missouri Community Action (CMCA) and Court Appointed Special Advocate (CASA).  This was an interactive event promoting poverty awareness, increasing understanding and promoting local change.

Below are some upcoming events such if you are interested:

• Poverty 101, October 17 from 3:00-5:00 p.m. at Jefferson City First United Methodist Church (JCFUMC).   This is an overview of local poverty statistics, interactive low-income family scenario, followed by Q&A.
• Bridges Out of Poverty, November 6 from 9:00 a.m. to 4:00 p.m. at JCFUMC.  This is a in-depth review of poverty research and change theory.   Broad overview of proven concepts and strategies.
• Friends/Transformational Housing Training, December 8 from 5:30 to 7:30 p.m. will prepare to volunteering in upcoming Friends program or to assist families in Transformational Housing.
• Human Library, January 10 from 4:00 - 7:00 p.m. at JCFUMC.  Challenge stereotypes, prejudice, stigmatism and discrimination through open dialogue.

Moving On Up.....

Congratulations to the following MHD employees:

• Nancy Silva was promoted to a Benefit Program Specialist in TPL, replacing Nikki Graham. 
• Lori Wilson was promoted to a Program Specialist position in Program Operations replacing Matt McTeer.   In her new position, Lori will be managing the School District Administrating Claiming (SDAC) and School-Based Services programs.
• Danica Bialczyk was promoted to the Data Research Analyst position in the Managed Care Quality Oversight Unit.  Danica’s knowledge and professionalism will be great assets to our team as we continue to improve Quality through our Managed Care program.
• Kristina Kleinheider was promoted to a Benefit Program Sr. Specialist in the Medicare Buy-In Unit.  She had previously worked in the unit for many years and has a vast knowledge she will be bringing back. 
• Jordan Potter joined the Drug Rebate Team as a Benefit Program Sr. Specialist replacing Cassi Dreschel.  

Welcome Aboard

Tyler Batican joined the Medicare Buy-In Unit as a Lead Administrative Support Assistant.    He formerly worked at WIPRO. Tyler lives in California, Mo and has a 4 year old daughter and 12 year old son. Welcome to the team Tyler.

Miranda Darnell joined the Medicare Buy-In Unit as a Lead Administrative Support Assistant.   She comes to us from the Department of Revenue.  She has an Associates Degree in Business Administration with a specialty in health. Miranda's hometown is Jerome and currently resides in the Brazito/Henley area with her husband, 3 kids, 2 dogs and a cat.   Now that's a houseful. Miranda enjoys crafting.   A little known fact is that she went to college to be a radiological tech but then switched to business.

Marquita 'Kita" McClain joined the Medicare Buy-In Unit as a Benefit Program Specialist.  She comes to us from the Family Support Call Center. Kita is pursing a Masters in Criminal Justice. Kita's hometown is Chicago and currently resides in Jefferson City.    She has 2 girls, 1 boy and 1 Cane Corso dog. Kita enjoys gardening and painting.   She said she also loves to travel, cook and "absolutely loves" wine, and people with a sense of humor!

Tammy Tice decided to "hang it up" after 24+ years of service on September 30.   She has been a valuable team member to the Medicare unit. She spent many years in the Provider Enrollment Unit and Provider Relations before coming to the Medicare unit. She will be greatly missed.

Rebecca Logan retired after 22 years of service with the State of Missouri.   She has been a great asset to MO HealthNet and the Managed Care organization.  Sounds like she plans to do a lot of traveling.   Good luck Rebecca!

Training Opportunities...

Jira Service Desk Report Request Training is now available! Please complete the questions below and email to Zana Stephenson to enroll.  Each class is limited to 15 participants.

Training objectives: After the session, the user should be able to discuss the new process, navigate the application, create and submit report requests, navigate queues, and update and cancel requests. This course is designed with the flexibility that these objectives can be met based on the JSD roles of the participants in each session.

Name of attendee:

Attendee email:

Is the attendee already provisioned for JSD? Yes  No Unknown

Attendee role: Data Steward       Cognos User       TOAD/SQL User       Other: 

Training Date:  

Employment Opportunities

Do you have a friend or family member looking for a career change or job opportunity?   Are you looking for a career development/promotional opportunity?  Visit  MO Careers to view & apply for  current job openings.   Below are a few positions currently open:

• Occupational Health & Safety Consultant with DNR.  Closes October 7.
• Research Data Analyst with DNR.  Closes October 6.
• Accountant III with Office of State Courts Administrator.  Closes October 8.
• Benefit Program Tech with FSD.  Closes October 6.

MHD  Connection News

Happy October Everyone!!   It's going to be a "Spooktacular" month.   Time to dig out the costumes and Halloween stuff. 

We hope you are enjoying the food trucks.   

Do you have a family recipe you'd like to share that we can post on the Recipe Corner on the intranet page or in the newsletter, etc.  If would like to submit an item just email MHD Connection at MHD.Connection@dss.mo.gov or to me.

Following are Staff Forums scheduled for the remainder of the year:

• October 13 - Diabetes
• November 17 - Waiver Programs
• December 8 - Inclusion Workforce

Upcoming events planned:

• Boo Grams will go on sale October 18-27.   Watch for flyers and emails for details.
• Bagel/Donut days each month.  I promise to order more bagels this time!!

Please feel free to share your ideas with any committee member: Gail Luecke (Chairman),  Nanci Nikodym (Treasurer), Pam Burris, Karen Pendleton, Stephanie Hunt, Bridgette Hicks, Stacie Gibson, Sheana Wilcox, Lori Parrish, and Carolyn Twardowski (secretary). 

What's Cooking at MHD?

Send me a note if you've tried any of the recipes and what you thought.  Keep those recipes coming and enjoy these delicious treats!!  Here are a couple of those recipes featured on The Recipe Corner.  

MHD Calendar & Area Events

Visit our Calendar of Events page for WEBEX Meeting Info

10-06  Halls Kitchen Food Truck

10-6  St. Louis Cardinal "Play Off" Day - Wear your shirts 

10-07  Ozark Mountain Biscuit Food Truck

10-11  STATE HOLIDAY - Columbus Day

10-13  Bagel/Donut Day

10-18  Boo Grams go on sale.   

10-19   Filipino Favorites Food Truck

10-20  Zydeco's Food Truck (FSD)

10-27  MHD Halloween & Costume Team Building Day

10-28   Red Cross Blood Drive in Conference Room 202

10-31   Halloween

Hey! Stay outta my can, will ya?!!! The Howerton Building offers multiple recycling options: Paper — Large green Dumpster bins throughout the building for non-confidential paper; gray bins with slotted lids for confidential paper. Cans and Bottles — Containers in all galleys, including Center Court, for plastic bottles and aluminum and “tin” (soup) cans. Cardboard — Rolling bins just inside the dock area on the first floor for cardboard. Plastic Bags — A box in Center Court for clean plastic bags. Questions: Feel free to contact Jennifer Parker at 526-1165 jennifer.j.parker@dss.mo.gov  or John Mier at 751-7079 or John.R.Mier@dss.mo.gov “Trash cans are for icky stuff — which I love!” — Oscar

REMINDERS CONFERENCE ROOMS:  Please remove meetings from the conference room calendars if you know that staff will be attending your meeting remotely and you will not need the conference room.   Please refrain from reserving conference rooms for 2 or 3 people if there is an office available. KEEP YOUR OUTLOOK CALENDARS UPDATED PLEASE!   This includes scheduled days off, meetings, trainings, etc.  By doing this it will help immensely to ensure meetings are scheduled within your work hours and help staff working deadlines to be able to plan around planned absences or if they need to reach you.  Thank you.