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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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(1) The Contractor is prohibited from using any source of funds contained within <br />the MAC budget unit until they have been assessed and determined <br />appropriate; <br />(2) The Contractor must complete the assessment annually and submit the <br />assessment to the HCA Contract Manager no later than January 31 st or within <br />thirty (30) business days of completion, whichever comes soonest; <br />(3) If the assessment determines any portion of the scope of work overlaps with <br />MAC activities, the entire cost objective is deemed to overlap and is prohibited <br />from being used as CPE; and <br />(4) Required to identify costs that must be offset, and verify the remaining net <br />costs are allowable for inclusion in the MAC program and eligible for FFP <br />reimbursement. <br />8. SKILLED PROFESSIONAL MEDICAL PERSONNEL (SPMP) <br />Contractor staff who have completed a two -or -more -year program leading to an academic degree or <br />certificate in a medically related profession, demonstrated by possession of a medical license, <br />certificate or other document issued by a recognized National or State medical licensure or certifying <br />organization, or a degree in a medical field issued by a college or university certified by a <br />professional medical organization are eligible for a seventy five percent (75%) enhanced <br />reimbursement for specific MAC activities. Years of experience in the administration, direction, or <br />implementation of the Medicaid program is not considered the equivalent of professional training in a <br />field of medical care. The Contractor is permitted to perform SPMP activities as directed by HCA's <br />Chief Medical Officer (CMO) to assist in achieving HCA's goals and administering the Medicaid State <br />Plan. <br />The Contractor must: <br />a) Monitor and ensure that FFP reimbursement for SPMP activities are in compliance with all <br />federal, state, HCA and CMS Regulations, the CAP, Manual and this Agreement. Federal <br />requirements include 42 CFR § 432.2, 432.45, 432.50, and 433.15; <br />b) Have all forms and documents supporting the designation of an SPMP entered into the <br />System and retained according to the SOS record's retention schedule; <br />c) Not, and is prohibited from, requesting seventy five percent (75%) enhanced <br />reimbursement for: <br />Any staff who are not certified as an SPMP, as stated above; <br />ii. Any staff whose position descriptions do not require certified SPMP duties or <br />responsibilities; <br />iii. Any staff who are not directly employed by the Contractor; <br />iv. Medical assistance expenditures; <br />V, Any SPMP activities that are not directed by HCA's CMO and explicitly described in this <br />Agreement (All other allowable MAC activities performed by an SPMP are eligible for <br />50% FFP); and <br />Local Health Jurisdiction Page 57 of 59 Medicaid Administrative Claiming <br />Washington State Health Care Authority Contract # K3069 <br />
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