2016-12-20-WA-healthcare-authority

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DocuSign Envelope ID : 78C00168-656B-44E9-9F46-9AFBF222884F iii) All data used to calculate the FFP must be the actual cost/expenditure and not approximated; iv) The FFP is determined by calculating the total adjusted costs, multiplying these costs by the adjusted RMTS results, and the applicable Medicaid Eligibility Rate (MER), adding any direct charges, and then applying the appropriate FFP rate; v) The invoice must be generated within one hundred twenty (120) calendar days of the end of the quarter; and vi) The invoice is generated based on following five components: (1) Cost pool construction; (2) Calculating allowable Medicaid administrative time via the System or direct charge method and documentation; (3) Calculation and application of the pertinent MER; (4) Calculation and application of the indirect cost rate ; and (5) Application of the appropriate FFP rate. b) Cost pool construction i) The Contractor must comply with all federal, state, HCA and CMS Regulations, the CAP, Manual, and this Agreement when constructing cost pools. ii) The Contractor is prohibited from including any unallowable costs in any cost pool. iii) The Contractor must include all costs used to calculate the FFP reimbursement to one of these six cost pools : (1) Cost Pool 1 : MAC SPMP; (2) Cost Pool 2: MAC Non-SPMP; (3) Cost Pool 3a and 3b : Non-MAC; (4) Cost Pool 4: MAC Direct Charge -enhanced; (5) Cost Pool 5: MAC Direct Charge -non-enhanced ; and (6) Cost Pool 6: Allocated . iv) Costs included in the calculation of an indirect cost rate are prohibited from being assigned to any of the six cost pools except by application of the indirect cost rate . v) All costs assigned to each cost pool must be allowable and comply with the descriptions in the CAP and Manual. State of Washington Health Care Authority Page 35 of 42 HCA Contract No. K1407-1