High Fidelity Wraparound (HFW) Claiming, Reporting, and MAPP Health Home Tracking System (HHTS)

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March 7, 2025

To: Health Home Serving Children and HFW Care Management Agencies

The Medicaid Analytics Performance Portal Health Home Tracking System (MAPP HHTS) currently contains a system defect when billing for High Fidelity Wraparound (HFW) care management services and the following outlines steps that will be taken to resolve the issue and the requirements of the Health Homes.

The High Fidelity Wraparound (HFW) care management service requires that the exact date in which the member and HFW care manager determined eligibility and enrollment in HFW needs to be documented as the service date (Program Type Begin Date) to bill the HFW rate per member per month (PMPM), if all other HFW requirements are met. The MAPP HHTS defect is determining any service date that is not the first of the month, will not qualify within that month. This means that if a member is flagged within MAPP HHTS as HFW effective February 5, 2025, the member will not qualify for the HFW rate until March 1, 2025. This defect will be corrected in the summer 2025 MAPP HHTS release 4.8.

Please be advised of the following short-term solutions:

  1. Data Fix – MAPP HHTS will create a data fix to change all HFW records so that the Program Type Begin Date is set to the first of the month (e.g. member HFW Program Type Begin Date of June 23, 2024, will be changed in this data fix to June 1, 2024).
    • MAPP HHTS will retain all past HFW Program Type Begin Dates for previous HFW members to be re-adjusted once the MAPP HHTS release 4.8 occurs.
  2. Provider Instruction Regarding Billing – for members with HFW Program Type Begin Date on or after January 1, 2024, who did not receive the HFW rate in their first month of being HFW eligible and enrolled, Health Homes must void/re-add that billing instance to receive the HFW rate in MAPP HHTS.
  3. Provider Instruction when Submitting HFW to HHTS – as of the date of this announcement, Health Homes must enter any new child’s HFW Program Type Begin Date as the first of the month but retain in the Health Home records the actual eligibility/enrollment date (Program Type Begin Date) .
    • After the MAPP HHTS release 4.8, Health Homes will need to change the HFW Program Type Begin Date to the actual service date. Additionally, once MAPP HHTS release 4.8 is implemented, Health Homes will be able to return to submitting the member’s actual HFW eligibility/enrollment date (Program Type Begin Date) .

Please Note: Until the MAPP HHTS release 4.8, Health Homes also must use the “Billing Support Upload” file to access the HFW rate. Providers cannot access the HFW rate using the member’s billing screen in the MAPP HHTS.

For any information/list of HFW enrolled children you can request this at MAPP CCC.