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Health Care Authority 2019
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12. December
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2018-12-18 10:00 AM - Commissioners' Agenda
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Health Care Authority 2019
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Last modified
12/13/2018 1:36:32 PM
Creation date
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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e) Calculation and application of the pertinent MER. <br />i. All MERs must be calculated quarterly; <br />ii. All MERs must be based on the quarter claimed; <br />iii. All MAC activities that that benefit the Contractors Clients directly and are performed <br />within a program that identifies Clients must use a Client -based MER as described in <br />the CAP and Manual; <br />iv. All MAC activities that benefit the Contractors Clients directly and are performed within <br />a program that operates a primary care or specialty clinic must use a clinic -based MER <br />as described in the CAP and Manual; <br />V, All MAC activities that benefit a larger population in the geographical region served by <br />the Contractor, or in programs that do not identify Clients or collect demographic data <br />must use the modified county -wide MER; and <br />vi. The Contractor is required to collect and maintain demographic data used to determine <br />Medicaid enrollment for all Clients served within budget units whose costs are included <br />in the FFP reimbursement. The Contractor is prohibited from including clients from any <br />budget unit that is not allowable within the MAC program. <br />(1) All data related to Medicaid enrollment and the MER must be maintained <br />according to the SOS records retention schedule; <br />(2) The information collected must be sufficiently detailed to determine Medicaid <br />enrollment through HCA's ProviderOne System; <br />(3) The information must be entered in the Contractor's Client information System or <br />data base; <br />(4) The Contractor must produce a single electronic list of all unduplicated Clients <br />served over the quarter within thirty (30) business days of the end of the quarter; <br />(5) The Contractor is prohibited from including the same Client more than once <br />(duplicating) on the quarterly list; and <br />(6) The Contractor must submit the quarterly list to either their third party System <br />operator or other System operator which calculates the Client -based and clinic - <br />based MER. <br />f) Calculation and application of the indirect cost rate <br />All indirect cost rates must be developed in accordance with all applicable <br />regulations and guidelines including the 2 CFR Chapter I, Chapter Il, part 200, et <br />al (OMNI Circular); <br />The Contractor is required to have an indirect cost rate proposal approved by their <br />Cognizant Agency; <br />iii. The Contractor is required to certify the accuracy of the indirect cost rate annually <br />using HCA form 02-568 Certificate of Indirect Costs; <br />Local Health Jurisdiction Page 54 of 59 Medicaid Administrative Claiming <br />Washington State Health Care Authority Contract # K3069 <br />
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