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Health & Human Services Local Health Department/District Medicaid Administrative Claiming (MAC)

Welcome to the. Health & Human Services Local Health Department/District Medicaid Administrative Claiming (MAC) Overview. The Purpose of MAC.

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Health & Human Services Local Health Department/District Medicaid Administrative Claiming (MAC)

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  1. Welcome to the Health & Human Services Local Health Department/District Medicaid Administrative Claiming (MAC) Overview

  2. The Purpose of MAC • To provide Local Health Department (LHD’s) the opportunity to submit reimbursement claims for administrative activities that support the Medicaid program such as: • Medicaid Outreach • Medicaid Referral, Coordination, and Monitoring • Medicaid Transportation and Translation • Medicaid Provider Relations

  3. The Benefits of MAC • Generate Revenue from MAC claim submission • Dedicated to the provision of health services • May be used to enhance services at the LHD’s • by improving and/or expand the level and quality of health/medical services provided to clients within the community

  4. Participant List Participant Identification Random Moment Time Study MAC Financial Data Collection MAC Claim Calculation Determine who performs MAC activities Determine how much reimbursable activity is performed Determine actual costs associated with these activities Apply reimbursement rates (TS, MER, IDCR) to calculate a claim MAC Process

  5. How to get started in MAC • Interagency Agreement • Direct Deposit Form • Vendor Information Form • Payee Number Application http://www.hhsc.state.tx.us/rad/mac/mac-contracting.shtml

  6. MAC Financial Contact Responsibilities • Serve as financial liaison between HHSC & Fairbanks LLC • Must attend MAC Financial Training at a minimum annually • Enter, verify and certify the MAC financial data on the system • Certify, notarize and submit quarterly MAC financial reports • Maintain financial documentation and supporting materials • Must be listed as the primary MAC Financial Contact • Trained Financial Contacts must maintain the accuracy of ALL Contacts in the cost reporting system

  7. What Cost can I report? • Compensation • Entity Employee Salaries • Payroll Taxes & Benefits • Only Report “True” Expenditures • If your entity sets funds aside for future Workers Comp claims then these “set aside” funds are not true expenditures. • Contracted staff • Revenues(Federal Revenues offset expenditures) Mr. Higgins, CPA

  8. Detailed Worksheet Psychologists and Interns Bob Employee Joe Employee Mary Contract Staff Category Summary Registered Nurse (RN) Salaries 30,000 Benefits 6,000 Purchased Svcs. 8,000 Functional Reporting • There are two options to enter financial data: • Participant Detail (Preferred) • Detailed basis by individual position • Group Summary • Provider category summary • Categories as entered on the participant list • If your entities enters at this level, they must keep the detail by position/individual in the audit documentation file.

  9. MAC Financial Reporting • MAC financial quarters will not be opened unless the following requirement are met: • Active contract with HHSC • Appropriate MAC & RMTS training for the FFY • RMTS Requirements are met • If you are unable to access the quarter, please contact the MAC team via email at: MAC@hhsc.state.tx.us

  10. Important Notice • LHDs participating in MAC • Please be aware that costs associated with MAC activity and claimed on the MAC claim may not be included as part of the cost report submitted for reimbursement under the Texas Healthcare Transformation and Quality Improvement 1115 Waiver Program.

  11. Time Study Periods • Federal Fiscal Quarters 1st Quarter - October, November, December 2nd Quarter - January, February, March 3rd Quarter - April, May, June 4th Quarter - July, August, September

  12. Important Dates for MAC Claim Submission Date Event Description Open Date Close Date 1st Quarter MAC Financials 02/18/2013 04/05/2013 2nd Quarter MAC Financials 05/27/2013 07/12/2013 3rd Quarter MAC Financials 08/19/2013 10/04/2013 4th Quarter MAC Financials 11/25/2013 01/10/2014 All important information, notices, claim due dates, etc can be found on the following website: http://www.hhsc.state.tx.us/rad/mac/mac-lhd.shtml This information along with additional updates may also be found on the Dashboard page of STAIRS web system.

  13. Contacts Medicaid Administrative Claiming – (512) 491-1802 – MAC@hhsc.state.tx.us(MAC Email Box) http://www.hhsc.state.tx.us/rad/mac/index.shtml (MAC Website) Yvonne Moorad - Team Lead Sandra Brabandt - LHDs STAIRS (State of Texas Automated Reporting System) & Website Questions – info@fairbanksllc.com Fairbanks Hotline: (888) 321-1225

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