The Bureau of Fiscal Management (BFM) is responsible for the administration, management, monitoring, and oversight of fiscal operations for Fee-for-Service (FFS), Physical Health HealthChoices Managed Care, and the Children’s Health Insurance Program (CHIP) delivery systems.
BFM is the lead on the Medicaid budget for these programs, which include planning, directing and management of the administrative and operating components of the applicable appropriations.
BFM manages the rate setting process for FFS programs, which includes provider specific rates for Inpatient Hospitals, Federally Qualified Health Centers, Rural Health Centers, various program exception requests, and the Medical Assistance Transportation Program.
Additionally, BFM manages the prospective capitation rate development for both Physical Health HealthChoices Managed Care Organizations (MCOs) and CHIP, as applicable. BFM also manages the actuarial services contract that support all of Department of Human Services (DHS) which in addition to OMAP includes the Secretary’s Office, the Offices of Long-Term Living (OLTL), Mental Health and Substance Abuse Services (OMHSAS), and Developmental Programs (ODP).
Divisions
This division manages the development of the program office budget for the Medicaid program and applicable administrative appropriations for submission to the DHS Budget Office. This includes managing the allocation of OMAP funds and the monitoring of expenditures to identify deviations from projections and corrective action strategies. This division also monitors the transportation providers and counties proposed budgets versus the actual costs and provides guidance and approval. The division is also responsible for the financial process of contracts and renewals for Bureau of Managed Care Operations (BMCO) and BFMs contracts.
Division Chief: Amy Brandt
This division develops and issues HealthChoices financial reporting requirements and manages the Electronic Financial Reporting and Monitoring (EFRM) system in addition to assessing the fiscal ability of the MCOs to fulfill contract payment obligations.
- Division Chief: Joe Skolnicki
This division manages the rate setting process for the Physical HealthChoices Managed Care Program and the Actuarial Service Contract for OMAP, ODP, OMHSAS and OLTL. In addition, this division manages HealthChoices rate impact on revenue enhancement arrangements including the hospital assessment, Gross Receipts Tax, Access to Care and the Managed Care Assessment.
- Division Chief: Danielle Schreader
This division performs rate setting functions for federally qualified health centers, rural health clinics, acute care, psychiatric and rehabilitation hospitals and units, including the calculation of Disproportionate Share and medical education pass-through payments. In addition, this division is responsible for the maintenance, disbursement and reporting on more than 30 hospital payment programs.
- Division Chief: Maki Traynor
This division manages and administers Home Nursing Risk Sharing, High-Cost Risk Pools, Health Insurance Providers Fee for DHS Gross Receipts Tax and MCO Assessments for PH-MCOs. In addition, this division is responsible for developing non-rate financial HealthChoices agreement terms and determines and issues requirements and obligations of MCOs.
- Division Chief: Mike Bocan
Bureau Information
Director
- Michele Minter
Managed Care Financial Manager
- Bree Zappe
Contact Information
- Phone: 717-772-6300
- Fax: 717-705-8112