Medicaid Admin Claiming - Laserfiche WebLink

Home Browse Search

DocuSign Envelope ID : 4166FC64-6496-4305-8555-38A174BDAA73 "Effective Date" means the first date this Contract is in full force and effect. It may be a specific date agreed to by the parties; or, if not so specified, the date of the last signature of a party to this Contract. "Eligible Staff'' or "Participant" or "RMTS Participant" means an employee of the Contractor that is in compliance with all federal, state , and HCA regulations including this agreement, the CAP, the Manual, CMS guidance, and any other requirements for participation in the Medicaid Administrative Claiming program and whose costs are eligible for claiming their staff time costs for conducting Medicaid Administrative Claiming activities. "Federal Financial Participation" or "FFP" means the federal payment (or federal "match") that is available at a rate of 50% for amounts expended by a state "as found necessary by the Secretary for the proper and efficient administration of the state plan" per 42 CFR § 433.15(b)(7). An enhanced FFP rate of seventy five percent (75%) is available for certain SPMP or interpretation administrative costs. Only permissible, non- federal funding sources are allowed to be used as the state match for FFP. "Fiscal Coordinator" means the Contractor's employee who is assigned to b~ the liaison between HCA and the Contractor for the accounting purposes of this Agreement. The contractor may assign the fiscal and RMTS coordinator roles to the same staff if desired. "HCA Contract Manager" means the individual identified on the cover page of this Contract who will provide oversight of the Contractor's activities conducted under this Contract. "Health Care Authority" or "HCA" means the Washington State Health Care Authority, any division, section , office, unit or other entity of HCA, or any of the officers or other officials lawfully representing HCA. "Indirect Cost" means an Operating Expense that is allocated across more than one program. Indirect costs are only allowable for FFP reimbursement by the application of an Indirect Cost Rate approved by the Contractor's Cognizant Agency. The indirect cost must be certified by the Contractor annually using the HCA Certificate of Indirect Costs form. "Indirect Cost Rate" means the ratio, expressed as a percentage, of the indirect costs to a direct cost base as approved by the Contractor's Cognizant Agency. "Integral Activity" or "Extension Activity" means an activity that. is necessary for or incidental to the provision of a direct medical service. "MAC Activity" or "Allowable Activity" or "Reimbursable Activity" or "Claimable Activity'' means an activity that is administrative in nature, and necessary for the proper and efficient administration for the Medicaid state plan which must be in compliance as described in applicable federal, state, HCA and CMS Regulations, the CAP, Manual, and this Agreement. "Manual" or "Coordinator Manual" means the document that describes how the Contractor must implement the CAP locally and includes detailed instructions for implementing and monitoring the MAC program at the local level. The Manual is incorporated into this Agreement by reference . Local Health Jurisdiction Washington State Health Care Authority Page 7 of 59 Medicaid Administrative Claiming Contract # K3069