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Docusign Envelope lD: C1 90C649-709E-4E0GA409-4A'I 6CED8C800 <br />Administrative Fee <br />HCA charges MAC contractors an Administrative Fee to offset HCA's costs for the <br />administration of the MAC program. The rate is based on the costs associated with the staff <br />effort spent on MAC related work for an entire State Fiscal Year (SFY) and is billed as a line <br />item on the quarterly claim form A-19-1A submitted by the MAC contractor. This cost is <br />divided by the dollar amount of administrative claims submitted by the participating <br />contractors in the MAC program for the same SFY. The calculated rate is used on the claims <br />for the subsequent SFY. At the end of the period, the rate used will be validated using the <br />actual claimed expenditures for that period and any variances will be settled with the <br />contractor during the second quarter of the new SFY. <br />HCA Responsibilities <br />Health Care Authority is responsible for performing oversight of the Contractor's MAC <br />program to ensure the effective administration of the MAC program and complying with all <br />rolei, responsibilities, limitations, restrictions, and documentation requirements described in <br />the CAP, Manual, and this Agreement. <br />lncluding but not limited to the following: <br />T .1. Maintain oversight of the Contractor's MAC program and monitoring activities <br />including review of all components of the time study, claiming, training, or anything <br />MAC related. <br />6. <br />7 <br />7.2 Direct the MAC activities reimbursable at the enhanced seventy five percent (75%) <br />rate for all Skilled Professional Medical Personnel (SPMP) participating in the <br />Contractor's MAC program. <br />Review the Contractor's monitoring activities to ensure monitoring is occurring and <br />any identified issues are addressed as deemed appropriate by HCA. <br />This will include but is not limited to the following: <br />7.3.1. Review of time study responses; <br />7.3. <br />7.4 <br />7.5 <br />7.3.2. <br />7.3.3. <br />Accuracy of coding; <br />Appropriateness of code changes; Sufficiency of backup <br />documentation; and <br />7.3.4. Non-responserates. <br />Verify the Contractor has entered all necessary data into the System and verify all <br />data entered was certified by the Contractor as accurate. <br />Review all claimed costs prior to issuing reimbursement to ensure they are <br />allowable, reasonable, and are supported by documentation that is sufficiently <br />detailed to permit HCA, CMS, or others to determine whether the costs are <br />Washington State <br />Health Care Authority <br />HCA Contract #K8630 <br />Attachment 5 <br />34