ODMRDD - Fiscal Administration MAC Local Coordinator Training

ODMRDD - Fiscal Administration

MAC Local Coordinator Training

Ohio Dept of MR/DD

Spring 2008


MAC Training Agenda Review of Coordinator’s role Reminders & Requests Status of CMS Review Review of the MAC process

• Access to Online System• Implementation Plans• On-line Rosters• Time Study/Activity Code review• Claim preparation, submission, and review

Resources and contact information


MAC Facts

During the initial three claiming periods, approximately 45 CB/COGs submitted claims each quarter.

Combined quarterly CB/COG claims exceeded $3 million per quarter.

Approximately 550 CB/COG staff participate in time studies each quarter.


Local MAC Coordinator’s Role

Provide overall direction and guidance on the MAC program to participants.

Confirm all eligible participants receive quarterly training at least two weeks prior to the time study period start date.

Complete all quarterly roster detail promptly (at least two weeks prior to the time study period start date).

Act as final “eyes” on participants’ time studies.


Confirm accuracy of quarterly claim financial data.

Ensure all errors are fixed prior to claim submission.

Ensure attestation of allowable matching funds occurs prior to claim submission.

Local MAC Coordinator’s Role-cont’d.


Train selected staff to serve as back-ups in case the local coordinator has an unexpected absence.

Use the state fiscal year instead of the calendar year when referring to the claim period. The state fiscal year runs from July 1 – June 30.

January-March = 3rd quarter SFYApril-June = 4th quarter SFYJuly-September = 1st quarter SFYOctober-December = 2nd quarter SFY

Payments and backcasting – All payments will be deferred until MAC Program is approved by CMS.

When you have questions, please email [email protected] to ensure timely and accurate responses.

Reminders & Requests


Status of CMS Review

Code changes: discounted vs. non-discounted Activity Codes 9,11, & 13 changed from non-

discounted to discounted Activity Code 15 was eliminated Activity Code 7 – still in discussion

ODMRDD responded to CMS request for online system access

Indirect costs: rate vs. current methodology


Access to the online system

Security affidavits are effective for 365 days once approved. Within 30 days of expiration, you will receive notification when you log onto the Department’s application portal. You can click on the link “Request a security affidavit” from the log-on page at the ODMRDD Applications Portal.

Passwords do expire. When this happens, you will be prompted to change it.

Forget your password? Click on the “forgot your password” option at the application portal, type in their username and email address. Security Support will send an automated message with needed information.


Implementation Plan

Why do we require an Implementation Plan (I/P)?

I/Ps contain information vital to administration of the MAC program.

MAC Coordinator contact info (& backup) Organizational structure Procedures for back-up coordinators to use in

unforeseen circumstances What positions are time study or 100% Medicaid Contractor info


Implementation Plan-cont’d.

The I/P must contain a list of personnel positions included in the MAC program for the entire year -- even if vacant -- and the codes allowed for each position.

ODMRDD is considering the use of a standardized form for future I/P submission to streamline process.


On-line Roster

When copying a quarterly roster to a subsequent period, please make sure all needed components of the quarterly roster to facilitate quarterly time study access (job titles, assigned codes, entry type, training dates, etc.) are filled in.

To ensure that all participants are able to access their time study, confirm that they are shown as “active” on both the master roster and the current quarterly roster.


Time Study

Once a MACSupervisor approves a time study, the employee cannot make changes to that time study unless the MACSupervisor unapproves it.

Please include this information in your quarterly trainings.


Activity Code 7/8 is more focused on managing an existing program that responds to individual needs

e.g., all phases of PAWS work & managing wait lists Activity Code 11/12 should be used for program planning

and collaboration with other entities to deliver and coordinate services

e.g., developing plans for expanding services Activity Code 13/14 refers to recruiting and maintaining a

pool of providers e.g., provider fairs, recruitment materials, etc.

These codes cannot be used interchangeably.

Time StudyActivity Code Clarification


Use Activity Code 18 only after confirming that other MAC codes are not applicable.

If a participant uses Activity Code 18 excessively, consider whether this person

should time study.

Time StudyActivity Code 18


Appropriate uses of Activity Code 19: Leave without pay Personnel who did not receive training Time not documented

Activity Code 19 should rarely be used! Be sure to review time studies carefully where this

code is used.

Time StudyActivity Code 19


Analysis of 3 quarters of MAC coding shows: Activity Code 18 was used more than any other code

(an average of 53% of the time)

Activity Code 19 was the 4th most applied code, at 6.3% of the time

These are red flags!

Be sure to check claims to ensure proper use of these codes and train staff in their appropriate usage.

Time StudyCode Usage Report


Time StudyLunch and Leave Coding

Unpaid lunch – Do not code. Leave entries blank.

Paid lunch – Use appropriate code.

Unpaid leave (leave without pay) – Use Activity Code 19.

Paid leave – Use Activity Code 18.


Claim Preparation

Why include 10% indirect costs in your claim? MAC claims are reconciled against annual

cost reports Reconciliation of cost reports may not be

completed until 2 years after MAC claims are submitted.

Federal regulations view claims for indirect costs after 2 years as “new costs” and, therefore, prohibited.


Actual payroll and fringe costs must be entered into the system. Please do not enter estimated costs.

If a contractor did not submit an invoice during the quarterly claiming period, contact the MAC Administrator to unlock your quarterly roster. Then change the contractor’s status to “inactive” for that quarter.

Claim Preparation


Claim Submission

Please confirm that all participants have approved time studies and all quarterly salary/fringe amounts have been entered prior to calculating and submitting the claim.

If time studies are not approved before calculating the claim, the claim may be submitted without those participants’ salaries included. This will reduce your claim amount.


Remember to “attest” to matching fund and claim calculations statements prior to notifying the MAC Administrator of completed resubmission of their quarterly claim.

Claims must include an attestation ensuring JFS and CMS that allowable matching funds were used. This attestation must occur every time a claim is submitted.

Claim Submission-cont’d.


To confirm whether your quarterly claim has been successfully submitted to the on-line system:

Select the Create a Report function from the main menu

Select Print a Medicaid Administration Claim Select a claim period Claim has been submitted if a name

appears in both the matching fund certification and attestation of accuracy.

Claim Submission-cont’d.


Claim Reviews

Why review??

Claims go through a review process at ODMRDD and ODJFS. In the future, audits will be performed as well. Findings will be issued against claims that contain errors or are not supportable. In such cases, the entity will be required to pay back the Federal reimbursement they have received for that claim.


ODMRDD reviews revealed that incomplete time studies were approved and submitted in claims.

Descriptions of activities should clearly support

the codes used and sufficiently explain the task performed for every 15 minute unit.

These are good topics to include in your quarterly training information.

Claim Reviews-cont’d.


MAC ResourcesOnline Help

http://odmrdd.state.oh.us/counties/mac.htm

What’s available? Links to MAC PowerPoint presentations and

other training materials MAC IT Participant and Coordinator User

Guides Security affidavit for access to MAC online Contact information


Individual MAC Costs by Code report provides information for the annual county cost reports

To access this report: If needed, complete a security affidavit for access to

CRN_MACReports_County_COG. Click on the CRN button from the applications menu. Choose Go to CRN ReportNet Choose MAC (County\COG)

What other reports would help you?

MAC ResourcesCognos Report Available


Reminders

The deadline for next quarterly roster:April 18th

The next time study week:May 3 – May 9

Notify staff no earlier than: April 26th


On-line MAC system help:[email protected]

Technical assistance with security affidavits:

[email protected]

MAC Contacts


Jenny JonesODMRDD MAC [email protected]: 614-644-7028

Division of Fiscal AdministrationRhodes State Office Tower30 E. Broad Street, 13th FlrColumbus, Ohio 43215

MAC Contacts


Final Thoughts

Questions ??

Feedback ??

Good-bye!

ODMRDD - Fiscal Administration MAC Local Coordinator Training

Technology

time studies

quarterly roster

time study

mac administrator

mac program

quarterly claim

claim reviews

security affidavit