Medi-Cal Administrative Activities (MAA) Program

The Medi-Cal Administrative Activities (MAA) Program 1 GRETCHEN SCHROEDER HEALTHREACH 510-501-2767 gschroeder@healthreachconsulting.com HealthReach 2014

What is MAA? 2 Reimbursement from Federal Medicaid for local public expenditures .when those expenditures support Medi-Cal outreach, access assistance, planning and other MAA activities. HealthReach 2014

Why MAA? 3 Leverage your current funding Leverage your current activities HealthReach 2014

Agenda 4 Financial Components of MAA MAA Reimbursable Activities How to Claim MAA Time Survey Invoices Audit File Q & A HealthReach 2014

MAA Financial Requirements 5 Staff funded with certified public expenditure (CPE) dollars who are performing MAA activities CPE match funds must be from a (federally allowable) public source (state general fund, county, city, school district, FIRST 5) Individuals do not need to be 100% CPE funded CPE funds cannot be used to match any other dollars HealthReach 2014

What Can We Claim For? 6 1. Medi-Cal Program 2. Medi-Cal Covered Services HealthReach 2014

Medi-Cal Covered Services 7 Medi-Cal pays for: Outpatient Clinics Dental Clinics Hospitals Physicians Dentists Optometrists Pharmacists ABA Services Speech Therapists Mental Health Providers Physical Therapists Psychologists Clinical Laboratories Skilled Nursing Facilities Substance Abuse Treatment Etc. HealthReach 2014

MAA Does NOT Include: Assisting with access to programs/services that are NOT HEALTH related, such as: WIC Housing Child Care CalFresh Unemployment Assistance Legal Services, etc. 8 HealthReach 2014

MAA Overview 9 Outreach to Assisting with Access Coordination of Services Program Planning Determining the need Gathering, analyzing, and presenting information Preparing proposals for new, improved, and/or expanded Medi-Cal covered services Medi-Cal Health Services Transportation Interpretation/ Translation Medi-Cal Application Assistance HealthReach 2014

Medi-Cal Outreach 10 To link potentially eligible individuals, families and groups to Medi-Cal eligibility sites for help in applying to Medi-Cal. Marketing Medi-Cal Handing out flyers/brochures To make referrals to Medi-Cal covered health services. HealthReach 2014

Assisting with Access 11 Coordinating Medi-Cal covered health services. Talking about client s Medi-Cal covered health services with providers and/or family Monitoring client s Medi-Cal covered health services Arranging or providing transportation to Medi-Cal covered health services. Giving directions Providing bus/van/taxi vouchers HealthReach 2014

Assisting with Access 12 Providing or arranging for interpretation/ translation services for Medi-Cal health service related issues. Assisting with the Medi-Cal application Assisting with the SSI application Assisting clients to maintain Medi-Cal eligibility HealthReach 2014

Program Planning 13 Determining the need Identifying and assessing gaps in Medi-Cal covered services Participating in intra- and interagency or community discussions on the Medi-Cal system or covered services Gathering, analyzing, and presenting information for program planning on Medi-Cal covered services Collecting and analyzing data Assessing the effectiveness of referral protocols, treatment plans, etc. Preparing proposals for new, improved, and/or expanded Medi-Cal covered services HealthReach 2014

How to Claim MAA 14 Local Governmental Agency (LGA) willing to work with you on MAA Claim plan Time surveys for staff performing MAA Quarterly invoices based on time survey results and costs of staff HealthReach 2014

Relationship With Your LGA 15 In order to claim MAA, you must work through your LGA. Enter in to contracts with your LGA for the purposes of MAA. Understand all of the State and your LGA s requirements for claiming MAA. HealthReach 2014

Administration of MAA CMS Centers for Medicare and Medicaid Services (Federal) I Department of Health Care Services (State) I Local Governmental Agency (County) I Subcontractors- CBOs, F5s, Schools, etc. 16 HealthReach 2014

MAA Claim Plan Who will participate in the time survey What activities those staff will perform Where and When these activities will be performed How staff will participate in these activities HealthReach 2014 17

THE MAA TIME SURVEY 18 Perpetual survey of paid work time Documents time spent on: MAA Reimbursable activities Non-Reimbursable activities General Administration Paid Time Off Matches agency time sheet Results are used to bill Medi-Cal HealthReach 2014

MAA Invoices 19 Submitted quarterly Have 15 months from the end of the quarter to submit Uses the MAA time from the time surveys and the eligible MAA costs for that quarter Usually paid within one year of submission HealthReach 2014

Assessment of Potential MAA Revenue 20 Identify staff or subcontractors who perform MAA Determine how much available public funds are used for those personnel costs Ascertain percentage of time dedicated to MAA Assisting with the Medi-Cal Application Medi-Cal Outreach Coordinating Medi-Cal covered services Assistance with transportation to Medi-Cal services Factor associated staff costs by time percentages to determine potential MAA revenue HealthReach 2014

MAA Reimbursement Calculation 21 Eligible Staff Costs ($100,000) X % of claimable activities (10%) X FFP (50%) = $5,000 MAA reimbursement HealthReach 2014