ADAMHS Benefit Plan

Sliding Fee Scale
Download the CY2020 Sliding Fee Scale HERE

Please note the change in date from July 1, 2017 to July 1, 2018 in several places in the FY18 Sliding Fee document. Transitions will start on July 1, 2017 as outlined in the attachment.

Effective July 1, 2017, the Montgomery Co. ADAMHS will begin transition to a new sliding fee scale. The sliding fee scale for Medicaid billable services will begin at 139% of the Federal Poverty Level.

In order to create a smooth transition to the sliding fee scale, agencies will be expected to transition individuals Based on the following guidelines:

  • New Individuals/Clients: Will immediately be placed on the new sliding fee scale beginning July 1, 2017.
  • Active/Open Individuals: Beginning, July 1, 2017 and each month thereafter through December 31, 2017, the “active” clients will transition to the new sliding fee scale at the time their 6 month financial review is completed. 
On January 1, 2017, all individuals will be transitioned completely to the FY17 sliding fee scale. The FY16 sliding fee rider codes will become “inactive” for any claims dated after January 1, 2017.
There are two ways for agencies to ensure they receive payment for Medicaid services for people who are 
Medicaid eligible after July 1, 2017:

  • Retro-Active Medicaid: Provide assistance to complete a Medicaid application and ensure the individual marks “YES” to the question “Do you want help paying for medical bills from the last three months?” (Question 12)
  • Presumptive Eligibility Medicaid: Become an agency certified as a “presumptive eligibility” Medicaid site and assist individuals in turning in an application via the presumptive eligibility process. This process will enable the agency to obtain a temporary Medicaid number for individuals until their Medicaid application is processed. It is important for agencies to move forward immediately with the presumptive eligibility Medicaid designation to ensure payment for services provided to new clients who meet Medicaid eligibility guidelines.

Open the revised Benefit Brochure for 2018