Transcript Medi-Cal Administrative Activities (MAA)

The Medi-Cal
Administrative Activities
(MAA) Program
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GRETCHEN SCHROEDER
HEALTHREACH
510-501-2767
[email protected]
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What is MAA?
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Reimbursement from Federal Medicaid
for local public expenditures
….when those expenditures support Medi-Cal
outreach, access assistance, planning and other
MAA activities.
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Why MAA?
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 Leverage your current funding
 Leverage your current activities
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Agenda
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 Financial Components of MAA
 MAA Reimbursable Activities
 How to Claim MAA
 Time Survey
 Invoices
 Audit File
Q & A
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MAA Financial Requirements
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 Staff funded with certified public expenditure
(CPE) dollars who are performing MAA
activities
 CPE
match funds must be from a (federally
allowable) public source (state general fund, county,
city, school district, FIRST 5)
 Individuals
 CPE
do not need to be 100% CPE funded
funds cannot be used to match any other
dollars
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What Can We Claim For?
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1. Medi-Cal Program
2. Medi-Cal Covered Services
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Medi-Cal Covered Services
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Medi-Cal pays for:
• Outpatient Clinics
• Dental Clinics
• Hospitals
• Physicians
• Dentists
• Optometrists
• Pharmacists
• ABA Services
• Speech Therapists
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• Mental Health Providers
• Physical Therapists
• Psychologists
• Clinical Laboratories
• Skilled Nursing
Facilities
• Substance Abuse
Treatment
• Etc.
MAA Does NOT Include:
Assisting with access to programs/services that
are NOT HEALTH related, such as:
•
WIC
•
Housing
•
Child Care
•
CalFresh
•
Unemployment Assistance
•
Legal Services, etc.
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MAA Overview
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Outreach to
• Medi-Cal
• Health Services
Assisting
with Access
• Coordination
of Services
• Transportation
• Interpretation/
Translation
• Medi-Cal
Application
Assistance
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Program
Planning
• Determining the
need
• Gathering,
analyzing, and
presenting
information
• Preparing
proposals for
new, improved,
and/or expanded
Medi-Cal
covered services
Medi-Cal Outreach
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• To link potentially eligible individuals, families
and groups to Medi-Cal eligibility sites for help in
applying to Medi-Cal.
•
•
Marketing Medi-Cal
Handing out flyers/brochures
• To make referrals to Medi-Cal covered health
services.
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Assisting with Access
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• Coordinating Medi-Cal covered health
services.
•
•
Talking about client’s Medi-Cal covered health
services with providers and/or family
Monitoring client’s Medi-Cal covered health
services
• Arranging or providing transportation to
Medi-Cal covered health services.
•
•
Giving directions
Providing bus/van/taxi vouchers
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Assisting with Access
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• Providing or arranging for interpretation/
translation services for Medi-Cal health
service related issues.
• Assisting with the Medi-Cal application
•
•
Assisting with the SSI application
Assisting clients to maintain Medi-Cal eligibility
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Program Planning
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Determining the need
•
•
•
Identifying and assessing gaps in Medi-Cal covered services
Participating in intra- and interagency or community
discussions on the Medi-Cal system or covered services
• Gathering, analyzing, and presenting information
for program planning on Medi-Cal covered services
•
•
Collecting and analyzing data
Assessing the effectiveness of referral protocols,
treatment plans, etc.
• Preparing proposals for new, improved, and/or
expanded Medi-Cal covered services
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How to Claim MAA
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 Local Governmental Agency (LGA) willing to
work with you on MAA
 Claim plan
 Time surveys for staff performing MAA
 Quarterly invoices based on time survey
results and costs of staff
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Relationship With Your LGA
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 In order to claim MAA, you must work
through your LGA.
 Enter in to contracts with your LGA for the
purposes of MAA.
 Understand all of the State and your LGA’s
requirements for claiming MAA.
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Administration of MAA
CMS
Centers for Medicare and Medicaid Services (Federal)
I
Department of Health Care Services (State)
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Local Governmental Agency (County)
I
Subcontractors- CBOs, F5s, Schools, etc.
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MAA Claim Plan
 Who will participate in the time survey
 What activities those staff will perform
 Where and When these activities will
be performed
 How staff will participate in these
activities
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THE MAA TIME SURVEY
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 Perpetual survey of paid work time
Documents time spent on:




MAA Reimbursable activities
Non-Reimbursable activities
General Administration
Paid Time Off
 Matches agency time sheet
 Results are used to bill Medi-Cal
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MAA Invoices
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 Submitted quarterly

Have 15 months from the end of the quarter to
submit
 Uses the MAA time from the time surveys
and the eligible MAA costs for that quarter
 Usually paid within one year of submission
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Assessment of Potential MAA Revenue
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 Identify staff or subcontractors who perform MAA
 Determine how much available public funds are
used for those personnel costs
 Ascertain percentage of time dedicated to MAA
• Assisting with the Medi-Cal Application
• Medi-Cal Outreach
• Coordinating Medi-Cal covered services
• Assistance with transportation to Medi-Cal services
 Factor associated staff costs by time percentages to
determine potential MAA revenue
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MAA Reimbursement Calculation
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Eligible Staff Costs ($100,000)
X
% of claimable activities (10%)
X
FFP (50%) =
$5,000 MAA reimbursement
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