Transcript www.hhsc.state.tx.us

Welcome to the
Health & Human Services
Local Health Department/District
Medicaid Administrative Claiming
(MAC)
Overview
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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
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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
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MAC Process
Participant List
Participant
Identification
Determine who
performs MAC
activities
Random Moment
Time Study
Determine how
much
reimbursable
activity is
performed
MAC Financial
Data Collection
MAC Claim
Calculation
Determine
actual costs
associated with
these activities
Apply
reimbursement
rates (TS, MER,
IDCR) to
calculate a claim
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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
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MAC Financial Contact Responsibilities
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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
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What Cost can I report?
• Compensation
 Entity Employee Salaries
Mr. Higgins, CPA
 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)
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Functional Reporting

There are two options to enter
financial data:
1. Participant Detail (Preferred)
• Detailed basis by individual position
2. Group Summary
Detailed Worksheet
Psychologists and Interns
Bob
Employee
Joe
Employee
Mary
Contract Staff
• 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.
Category Summary
Registered Nurse (RN)
Salaries
30,000
Benefits
6,000
Purchased Svcs.
8,000
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MAC Financial Reporting
 MAC financial quarters will not be opened
unless the following requirement are met:
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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:
[email protected]
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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.
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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
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Important Dates for
MAC Claim Submission
Date
Event Description
1st Quarter MAC Financials
2nd Quarter MAC Financials
Open Date
02/18/2013
05/27/2013
Close Date
04/05/2013
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.
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Contacts
Medicaid Administrative Claiming – (512) 491-1802 –
[email protected] (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 – [email protected]
Fairbanks Hotline: (888) 321-1225
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