Interagency Agreement between Wa Healthcare Authority and KC

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L/UUUDIIJ.I I CI IVCIUFJC IL . -, Ivw tj-+. -/ IUI.CVOIJ000 6. Administrative Fee HCA charges MAC contractors an Administrative Fee to offset HCA's costs for the administration of the MAC program. The rate is based on the costs associated with the staff effort spent on MAC related work for an entire State Fiscal Year (SFY) and is billed as a line item on the quarterly claim form A-19-1A submitted by the MAC contractor. This cost is divided by the dollar amount of administrative claims submitted by the participating contractors in the MAC program for the same SFY. The calculated rate is used on the claims for the subsequent SFY. At the end of the period, the rate used will be validated using the actual claimed expenditures for that period and any variances will be settled with the contractor during the second quarter of the new SFY. 7. HCA Responsibilities Health Care Authority is responsible for performing oversight of the Contractor's MAC program to ensure the effective administration of the MAC program and complying with all roles, responsibilities, limitations, restrictions, and documentation requirements described in the CAP, Manual, and this Agreement. Including but not limited to the following: 7.1. Maintain oversight of the Contractor's MAC program and monitoring activities including review of all components of the time study, claiming, training, or anything MAC related. 7.2. Direct the MAC activities reimbursable at the enhanced seventy five percent (75%) rate for all Skilled Professional Medical Personnel (SPMP) participating in the Contractor's MAC program. 7.3. Review the Contractor's monitoring activities to ensure monitoring is occurring and any identified issues are addressed as deemed appropriate by HCA. This will include but is not limited to the following: 7.3.1. Review of time study responses; 7.3.2. Accuracy of coding; 7.3.3. Appropriateness of code changes; Sufficiency of backup documentation; and 7.3.4. Non -response rates. 7.4. Verify the Contractor has entered all necessary data into the System and verify all data entered was certified by the Contractor as accurate. 7.5. Review all claimed costs prior to issuing reimbursement to ensure they are allowable, reasonable, and are supported by documentation that is sufficiently detailed to permit HCA, CMS, or others to determine whether the costs are Washington State 34 HCA Contract #K8630 Health Care Authority Attachment 5