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2018-12-18 10:00 AM - Commissioners' Agenda
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Health Care Authority 2019
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12/13/2018 1:36:32 PM
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12/13/2018 1:33:30 PM
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Meeting
Date
12/18/2018
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Supporting documentation
Supplemental fields
Alpha Order
p
Item
Request to Approve a Contract with the Washington State Health Care Authority for Professional Services for Medicaid Administrative Claiming
Order
16
Placement
Consent Agenda
Row ID
50104
Type
Contract
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vi. Submit any audit related to its MAC program to HCA within thirty (30) business days of <br />receipt of the final report. This includes but is not limited to SAO Audits, OMB Circular <br />Compliance Supplement Audits, Federal Reviews or Federal Audits. The contractor <br />must provide to HCA, any corrective action related to MAC findings and questioned <br />costs within thirty (30) business days of submission. <br />c) Abide by all roles, responsibilities, limitations, restrictions, and documentation requirements <br />including but not limited to those described in the CAP, Manual, and this Agreement. <br />2. RESPONSIBILITIES <br />a) The Contractor is responsible for monitoring its MAC program to ensure compliance with all <br />applicable laws, regulations and guidelines specific to the MAC program as described in this <br />Agreement and comply with all roles, responsibilities, limitations, restrictions, and <br />documentation requirements described in the CAP, Manual, associated federal and state <br />regulations, and this Agreement that includes, but is not limited to, the following. Only <br />expenses that are in reasonable and allowable, are permitted for reimbursement. HCA expects <br />the MAC program to be managed similarly to other federal awards and expects the RMTS and <br />Fiscal coordinators to report to, or work closely, with an administrator assigned oversight <br />authority of the LHJ. The Contractor must: <br />Only include staff in the claimed reimbursement (through the RMTS or direct charge <br />method) who are eligible to participate. The Contractor is prohibited from including any <br />staff in the RMTS or the claimed reimbursement unless their job positions comply with <br />the criteria described in the CAP, the Manual, and this Agreement. Staff who may be <br />eligible to be included in the RMTS or claimed reimbursement must: <br />(1) Not be included in another MAC time study or reimbursement claim; <br />(2) Be directly employed or contracted by the LHJ, or an HCA approved Subcontractor; <br />(3) Be reasonably expected to perform MAC related activities; <br />(4) Have all federal dollars appropriately off -set according to the CAP and Manual; <br />(5) Not be included in the calculation of an indirect cost rate that is used to calculate <br />FFP reimbursement; <br />(6) Not include any Federally Qualified Health Clinic (FQHC) staff (or expenses) whose <br />costs are included in the FQHC cost report; <br />(7) Be job positions that fit within these job categories: nurses, other medical <br />professionals, other professional classifications, community outreach and linkage <br />classifications, manager/supervisor/administrator classifications, or administrative <br />support classifications as described in the CAP and Manual; and <br />Designate staff for each of the following roles: RMTS Coordinator and Fiscal <br />Coordinator to be responsible for daily oversight and management of the Contractor's <br />MAC program; <br />(1) The RMTS and Fiscal Coordinator roles may be assumed by one individual if <br />desired. <br />Local Health Jurisdiction Page 45 of 59 Medicaid Administrative Claiming <br />Washington State Health Care Authority Contract # K3069 <br />
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