Laserfiche WebLink
DocuSign Envelope ID: 262ABAl8-5354-4F41-9508-91313C8ACBA6D <br />6.3.5. The Contractor may resume participation in the MAC program following the <br />prohibited quarter (5'h consecutive quarter); and <br />6.3.6. The Contract may be terminated if the eighty-five percent (85%) compliance <br />rate is not met after the Contractor resumes claiming. <br />Administrative Fee <br />HCA charges MAC contractors an Administrative Fee to offset HCA's costs for the administration of <br />the MAC program. The rate is based on the costs associated with the staff effort spent on MAC <br />related work for an entire State Fiscal Year (SFY) and is billed as a line item on the quarterly claim <br />form A -19-1A submitted by the MAC contractor. This cost is divided by the dollar amount of <br />administrative claims submitted by the participating contractors in the MAC program for the same <br />SFY. The calculated rate is used on the claims for the subsequent SFY. At the end of the period, <br />the rate used will be validated using the actual claimed expenditures for that period and any <br />variances will be settled with the contractor during the second quarter of the new SFY. <br />8. HCA Responsibilities <br />Health Care Authority is responsible for performing oversight of the Contractor's MAC program to <br />ensure the effective administration of the MAC program and complying with all roles, <br />responsibilities, limitations, restrictions, and documentation requirements described in the CAP, <br />Manual, and this Agreement. <br />Including but not limited to the following: <br />8.1. Maintain oversight of the Contractor's MAC program and monitoring activities including <br />review of all components of the time study, claiming, training, or anything MAC related_ <br />8.2. Direct the MAC activities reimbursable at the enhanced seventy five percent (75%) rate <br />for all Skilled Professional Medical Personnel (SPMP) participating in the Contractor's <br />MAC program. <br />8.3. Review the Contractor's monitoring activities to ensure monitoring is occurring and any <br />identified issues are addressed as deemed appropriate by HCA. <br />This will include but is not limited to the following: <br />8.3.1. Review of time study responses; <br />8.3.2. Accuracy of coding; <br />8.3.3. Appropriateness of code changes; Sufficiency of backup documentation; and <br />8.3.4. Non -response rates. <br />8.4. Verify the Contractor has entered all necessary data into the System and verify all data <br />entered was certified by the Contractor as accurate. <br />8.5. Review all claimed costs prior to issuing reimbursement to ensure they are allowable, <br />reasonable, and are supported by documentation that is sufficiently detailed to permit <br />Washington State Page 52 of 53 HCA IAA K4649 <br />Health Care Authority Revised 10/2020 <br />