What proportion of ECI Medicaid clients are enrolled in managed care organizations?
Response: ECI estimates that 61% of ECI clients with Medicaid are enrolled in MCOs. • Do MCOs have payment responsibility for any ECI services? Response: This depends upon the definition of an “ECI” service. The services under ECI in the State Plan (targeted case management for ECI clients and Developmental Rehabilitation Services [DRS]) are outside the capitated rate. It is likely that some providers who deliver other services (for example, physical therapy, occupational therapy, speech therapy, testing, and other related services) to Medicaid eligible children served by ECI may also provide services under an Individualized Family Service Plan to ECI children. HMO contracts include provisions for coordination with ECI. • Does ECI central office have an agreement with Medicaid to bill on behalf of local providers? Response: ECI central office processes payments for ECI providers for Developmental Rehabilitation Services. For other Medicaid “card” services, for example, physical therapy
