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Admatch K4649 Amendment 1
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2022-12-20 10:00 AM - Commissioners' Agenda
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Admatch K4649 Amendment 1
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Last modified
12/15/2022 12:19:18 PM
Creation date
12/15/2022 12:16:48 PM
Metadata
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Meeting
Date
12/20/2022
Meeting title
Commissioners' Agenda
Location
Commissioners' Auditorium
Address
205 West 5th Room 109 - Ellensburg
Meeting type
Regular
Meeting document type
Supporting documentation
Supplemental fields
Item
Request to Approve Amendment 1 to the Health Care Authority-Medicaid Admatch
Order
7
Placement
Consent Agenda
Row ID
97382
Type
Agreement
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DocuSign Envelope ID: 262ABAl8-5354-4F41-9508-91313C8ACBA6D <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 <br />a field of medical care. The Contractor is permitted to perform SPMP activities as directed by <br />HCA's Chief Medical Officer (CMO) to assist in achieving HCA's goals and administering the <br />Medicaid State Plan. <br />The Contractor must: <br />5.1. Monitor and ensure that FFP reimbursement for SPMP activities are in compliance with <br />all federal, state, HCA and CMS Regulations, the CAP, Manual and this Agreement. <br />Federal requirements include 42 CFR § 432.2, 432.45, 432.50, and 433.15. <br />5.2. 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 />5.3. Not, and is prohibited from, requesting seventy five percent (75%) enhanced <br />reimbursement for: <br />5.3.1. Any staff who are not certified as an SPMP, as stated above; <br />5.3.2. Any staff whose position descriptions do not require certified SPMP duties or <br />responsibilities; <br />5.3.3. Any staff who are not directly employed by the Contractor; <br />5.3.4. Medical assistance expenditures; <br />5.3.5. Any SPMP activities that are not directed by HCA's CMO and explicitly <br />described in this Agreement (All other allowable MAC activities performed by <br />an SPMP are eligible for 50% FFP); and <br />5.3.6. Any activities that are not directly related to the administration of the State <br />Medicaid plan. <br />5.4. Contribute to a quarterly SPMP report as needed by HCA and/or WSALPHO. Provide <br />details and additional information needed for the report as requested by HCA and/or <br />WSALPHO, within a mutually agreed upon time frame. <br />5.5. Participate in program planning and policy development meetings as requested by HCA. <br />5.5.1. The meetings will include discussions related to, but not limited to, reviewing <br />the SPMP reports and related topics or the effectiveness of the activities <br />performed in support of RCA's goals and the Medicaid State Plan. <br />5.6. Comply with any changes to the allowable SPMP activities as directed by the CMO. <br />5.6.1. Failure to comply with CMO directives may result in termination of SPMP <br />participation in the MAC program. <br />5.7. Monitor and ensure that all activities reimbursed at the seventy five percent (75%) <br />enhanced FFP are in support of the Medicaid State Plan and fall within the categories <br />Washington State Page 48 of 53 HCA IAA K4649 <br />Health Care Authority Revised 10/2020 <br />
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