MAC Local Coordinator Training Ohio Dept of MR/DD Spring 2008
MAC Training Agenda <ul><li>Review of Coordinator’s role </li></ul><ul><li>Reminders & Requests </li></ul><ul><li>Status o...
MAC Facts <ul><li>During the initial three claiming periods, approximately  45 CB/COGs  submitted claims each quarter. </l...
Local MAC Coordinator’s Role <ul><li>Provide overall direction and guidance on the MAC program to participants. </li></ul>...
<ul><li>Confirm accuracy of quarterly claim financial data. </li></ul><ul><li>Ensure all errors are fixed prior to claim s...
<ul><li>Train selected staff to serve as back-ups in case the local coordinator has an unexpected absence.  </li></ul><ul>...
Status of CMS Review <ul><li>Code changes: discounted vs. non-discounted </li></ul><ul><ul><li>Activity Codes 9,11, & 13 c...
Access to the online system <ul><li>Security affidavits are effective for 365 days once approved. Within 30 days of expira...
Implementation Plan <ul><li>Why do we require an Implementation Plan (I/P)?   </li></ul><ul><li>I/Ps contain information v...
Implementation Plan- cont’d . <ul><li>The I/P must contain a list of personnel  positions  included in the MAC program for...
On-line Roster <ul><li>When copying a quarterly roster to a subsequent period, please make sure all needed components of t...
Time Study <ul><li>Once a MACSupervisor approves a time study, the employee cannot make changes to that time study unless ...
<ul><li>Activity Code 7/8  is more focused on managing an existing program that responds to individual needs </li></ul><ul...
<ul><li>Use Activity Code 18 only after confirming that other MAC codes are not applicable. </li></ul><ul><li>If a partici...
<ul><li>Appropriate uses of Activity Code 19: </li></ul><ul><ul><li>Leave without pay </li></ul></ul><ul><ul><li>Personnel...
<ul><li>Analysis of 3 quarters of MAC coding shows :   </li></ul><ul><li>Activity Code 18 was used more than any other cod...
Time Study Lunch and Leave Coding <ul><li>Unpaid lunch –  Do not   code . Leave entries blank. </li></ul><ul><li>Paid lunc...
Claim Preparation <ul><li>Why include 10% indirect costs in your claim?   </li></ul><ul><ul><li>MAC claims are reconciled ...
<ul><li>Actual payroll and fringe costs must be entered into the system.  Please do not enter estimated costs. </li></ul><...
Claim Submission <ul><li>Please confirm that all participants have approved time studies and all quarterly salary/fringe a...
<ul><li>Remember to “attest” to matching fund and claim calculations statements prior to notifying the MAC Administrator o...
<ul><li>To confirm whether your quarterly claim has been successfully submitted to the on-line system: </li></ul><ul><ul><...
Claim Reviews <ul><li>Why review?? </li></ul><ul><ul><li>Claims go through a review process at ODMRDD and ODJFS.  In the f...
<ul><li>ODMRDD reviews revealed that incomplete time studies were approved and submitted in claims. </li></ul><ul><li>Desc...
MAC Resources Online Help <ul><li>http://odmrdd.state.oh.us/counties/mac.htm </li></ul><ul><li>What’s available? </li></ul...
<ul><li>Individual MAC Costs by Code report  provides information for the annual county cost reports </li></ul><ul><li>To ...
Reminders <ul><li>The deadline for next quarterly roster: </li></ul><ul><li>April 18 th </li></ul><ul><li>The next time st...
<ul><li>On-line MAC system help: </li></ul><ul><ul><li>[email_address] </li></ul></ul><ul><li>Technical assistance with se...
<ul><li>Jenny Jones </li></ul><ul><li>ODMRDD MAC Coordinator </li></ul><ul><li>[email_address] </li></ul><ul><li>Phone:  6...
Final Thoughts <ul><li>Questions ??  </li></ul><ul><li>Feedback ?? </li></ul><ul><li>Good-bye! </li></ul>
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ODMRDD - Fiscal Administration MAC Local Coordinator Training

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  • Remind everyone to sign in.
  • Before we start the agenda, here are some interesting facts for you.
  • Using SFY – to maintain consistency among sister state agencies PAYMENTS &amp; BACKCASTING – previously, expected payment for first 2 quarters of MAC program, now included in backcasting. Already reached SFY08 ceiling of $3.7M (based on prior year WAC payments). Backcasting may occur after CMS approval (ODE has been paid via backcasting process).
  • CODE CHANGES: MAC Committee (comprised of CB, COG and Department participants) recommended changes to the MAC Guide activity code section in response to comments from CMS’s guide review in Summer 2007 AC 9,11,13,15 : changes per CMS – not allowed. AC 7 : Discuss CMS saying only codes 3 &amp; 5 should be non-discounted. MAC Committee workgroup edited code 7 description and wrote an introductory statement explaining why code 7 should remain non-discounted. (CMS reason = consistency with sister agencies &amp; other states) Online access : be aware that CMS is reviewing entries online. Indirect cost : CMS is looking at this; speculation that they may request indirect cost reports be used instead of the current methodology (10% per claim, reconciled to audited report) Not in slide, but if questioned : Time study week span : CMS expressed concern with JFS’s random selections- starting any day of the week, including weekends. JFS in discussion—no news yet MER : CMS has asked questions – no news yet.
  • With respect to 100% positions : CMS is asking what codes the PD indicate should be used. Mac Coordinators should ask same question of self when considering whether to designate a position 100%. Note that the IP should discuss training plans, as well. (ask group to share training ideas if wish)
  • Distinction : The IP has all POSITIONS listed. We review the codes listed with each position to make sure the codes are appropriate. The on-line quarterly roster lists positions/personnel participating that quarter. Essentially a tool for managing who’s claiming in a quarter. You can’t be in a quarterly roster without being listed in the annual IP. Therefore, important to include all positions you plan to include in your claim for the whole year to the extent possible. Amendments are available, but should try to limit to unforeseen changes.
  • There has been some confusion around the use of these codes:
  • JFS REVIEW – excessive use of AC 18 is one thing DMR &amp; JFS is looking for. It may possibly affect ability to participate in program.
  • AC 19 is not to be used simply because the work is not Medicaid-related. Nature of the code structure is that there are corresponding non-Medicaid codes to use for activities.
  • AC 7 was distant second at 11.3%
  • Example of working lunch…during meeting for specific purpose e.g. Code XX for a working lunch on development of a daily rate billing unit.
  • 10% indirect costs are assessed quarterly
  • Why descriptions matter??? Audits can occur more than a year after the time study is completed
  • Note that other reports are being developed, but not yet ready.
  • 4/26 is a Saturday.
  • ODMRDD - Fiscal Administration MAC Local Coordinator Training

    1. 1. MAC Local Coordinator Training Ohio Dept of MR/DD Spring 2008
    2. 2. MAC Training Agenda <ul><li>Review of Coordinator’s role </li></ul><ul><li>Reminders & Requests </li></ul><ul><li>Status of CMS Review </li></ul><ul><li>Review of the MAC process </li></ul><ul><ul><ul><li>Access to Online System </li></ul></ul></ul><ul><ul><ul><li>Implementation Plans </li></ul></ul></ul><ul><ul><ul><li>On-line Rosters </li></ul></ul></ul><ul><ul><ul><li>Time Study/Activity Code review </li></ul></ul></ul><ul><ul><ul><li>Claim preparation, submission, and review </li></ul></ul></ul><ul><li>Resources and contact information </li></ul>
    3. 3. MAC Facts <ul><li>During the initial three claiming periods, approximately 45 CB/COGs submitted claims each quarter. </li></ul><ul><li>Combined quarterly CB/COG claims exceeded $3 million per quarter. </li></ul><ul><li>Approximately 550 CB/COG staff participate in time studies each quarter. </li></ul>
    4. 4. Local MAC Coordinator’s Role <ul><li>Provide overall direction and guidance on the MAC program to participants. </li></ul><ul><li>Confirm all eligible participants receive quarterly training at least two weeks prior to the time study period start date. </li></ul><ul><li>Complete all quarterly roster detail promptly (at least two weeks prior to the time study period start date). </li></ul><ul><li>Act as final “eyes” on participants’ time studies. </li></ul>
    5. 5. <ul><li>Confirm accuracy of quarterly claim financial data. </li></ul><ul><li>Ensure all errors are fixed prior to claim submission. </li></ul><ul><li>Ensure attestation of allowable matching funds occurs prior to claim submission. </li></ul>Local MAC Coordinator’s Role- cont’d .
    6. 6. <ul><li>Train selected staff to serve as back-ups in case the local coordinator has an unexpected absence. </li></ul><ul><li>Use the state fiscal year instead of the calendar year when referring to the claim period. The state fiscal year runs from July 1 – June 30. </li></ul><ul><ul><ul><li>January-March = 3 rd quarter SFY </li></ul></ul></ul><ul><ul><ul><li>April-June = 4 th quarter SFY </li></ul></ul></ul><ul><ul><ul><li>July-September = 1 st quarter SFY </li></ul></ul></ul><ul><ul><ul><li>October-December = 2 nd quarter SFY </li></ul></ul></ul><ul><li>Payments and backcasting – All payments will be deferred until MAC Program is approved by CMS. </li></ul><ul><li>When you have questions, please email mac.coordinator@odmrdd.state.oh.us to ensure timely and accurate responses. </li></ul>Reminders & Requests
    7. 7. Status of CMS Review <ul><li>Code changes: discounted vs. non-discounted </li></ul><ul><ul><li>Activity Codes 9,11, & 13 changed from non-discounted to discounted </li></ul></ul><ul><ul><li>Activity Code 15 was eliminated </li></ul></ul><ul><ul><li>Activity Code 7 – still in discussion </li></ul></ul><ul><li>ODMRDD responded to CMS request for online system access </li></ul><ul><li>Indirect costs: rate vs. current methodology </li></ul>
    8. 8. Access to the online system <ul><li>Security affidavits are effective for 365 days once approved. Within 30 days of expiration, you will receive notification when you log onto the Department’s application portal. You can click on the link “Request a security affidavit” from the log-on page at the ODMRDD Applications Portal. </li></ul><ul><li>Passwords do expire. When this happens, you will be prompted to change it. </li></ul><ul><li>Forget your password? Click on the “forgot your password” option at the application portal, type in their username and email address. Security Support will send an automated message with needed information. </li></ul>
    9. 9. Implementation Plan <ul><li>Why do we require an Implementation Plan (I/P)? </li></ul><ul><li>I/Ps contain information vital to administration of the MAC program. </li></ul><ul><ul><li>MAC Coordinator contact info (& backup) </li></ul></ul><ul><ul><li>Organizational structure </li></ul></ul><ul><ul><li>Procedures for back-up coordinators to use in unforeseen circumstances </li></ul></ul><ul><ul><li>What positions are time study or 100% Medicaid </li></ul></ul><ul><ul><li>Contractor info </li></ul></ul>
    10. 10. Implementation Plan- cont’d . <ul><li>The I/P must contain a list of personnel positions included in the MAC program for the entire year -- even if vacant -- and the codes allowed for each position. </li></ul><ul><li>ODMRDD is considering the use of a standardized form for future I/P submission to streamline process. </li></ul>
    11. 11. On-line Roster <ul><li>When copying a quarterly roster to a subsequent period, please make sure all needed components of the quarterly roster to facilitate quarterly time study access (job titles, assigned codes, entry type, training dates, etc.) are filled in. </li></ul><ul><li>To ensure that all participants are able to access their time study, confirm that they are shown as “active” on both the master roster and the current quarterly roster. </li></ul>
    12. 12. Time Study <ul><li>Once a MACSupervisor approves a time study, the employee cannot make changes to that time study unless the MACSupervisor unapproves it. </li></ul><ul><li>Please include this information in your quarterly trainings. </li></ul>
    13. 13. <ul><li>Activity Code 7/8 is more focused on managing an existing program that responds to individual needs </li></ul><ul><ul><ul><li>e.g., all phases of PAWS work & managing wait lists </li></ul></ul></ul><ul><li>Activity Code 11/12 should be used for program planning and collaboration with other entities to deliver and coordinate services </li></ul><ul><ul><ul><li>e.g., developing plans for expanding services </li></ul></ul></ul><ul><li>Activity Code 13/14 refers to recruiting and maintaining a pool of providers </li></ul><ul><ul><ul><li>e.g., provider fairs, recruitment materials, etc. </li></ul></ul></ul><ul><li>These codes cannot be used interchangeably. </li></ul>Time Study Activity Code Clarification
    14. 14. <ul><li>Use Activity Code 18 only after confirming that other MAC codes are not applicable. </li></ul><ul><li>If a participant uses Activity Code 18 excessively, consider whether this person should time study. </li></ul>Time Study Activity Code 18
    15. 15. <ul><li>Appropriate uses of Activity Code 19: </li></ul><ul><ul><li>Leave without pay </li></ul></ul><ul><ul><li>Personnel who did not receive training </li></ul></ul><ul><ul><li>Time not documented </li></ul></ul><ul><li>Activity Code 19 should rarely be used ! </li></ul><ul><li>Be sure to review time studies carefully where this code is used. </li></ul>Time Study Activity Code 19
    16. 16. <ul><li>Analysis of 3 quarters of MAC coding shows :  </li></ul><ul><li>Activity Code 18 was used more than any other code (an average of 53% of the time) </li></ul><ul><li>Activity Code 19 was the 4 th most applied code, at 6.3% of the time </li></ul><ul><li>These are red flags ! </li></ul><ul><li>Be sure to check claims to ensure proper use of these codes and train staff in their appropriate usage. </li></ul>Time Study Code Usage Report
    17. 17. Time Study Lunch and Leave Coding <ul><li>Unpaid lunch – Do not code . Leave entries blank. </li></ul><ul><li>Paid lunch – Use appropriate code. </li></ul><ul><li>Unpaid leave (leave without pay) – Use Activity Code 19. </li></ul><ul><li>Paid leave – Use Activity Code 18. </li></ul>
    18. 18. Claim Preparation <ul><li>Why include 10% indirect costs in your claim? </li></ul><ul><ul><li>MAC claims are reconciled against annual cost reports </li></ul></ul><ul><ul><li>Reconciliation of cost reports may not be completed until 2 years after MAC claims are submitted. </li></ul></ul><ul><ul><li>Federal regulations view claims for indirect costs after 2 years as “new costs” and, therefore, prohibited. </li></ul></ul>
    19. 19. <ul><li>Actual payroll and fringe costs must be entered into the system. Please do not enter estimated costs. </li></ul><ul><li>If a contractor did not submit an invoice during the quarterly claiming period, contact the MAC Administrator to unlock your quarterly roster. Then change the contractor’s status to “inactive” for that quarter. </li></ul>Claim Preparation
    20. 20. Claim Submission <ul><li>Please confirm that all participants have approved time studies and all quarterly salary/fringe amounts have been entered prior to calculating and submitting the claim. </li></ul><ul><ul><li>If time studies are not approved before calculating the claim, the claim may be submitted without those participants’ salaries included. This will reduce your claim amount. </li></ul></ul>
    21. 21. <ul><li>Remember to “attest” to matching fund and claim calculations statements prior to notifying the MAC Administrator of completed resubmission of their quarterly claim. </li></ul><ul><ul><li>Claims must include an attestation ensuring JFS and CMS that allowable matching funds were used. This attestation must occur every time a claim is submitted. </li></ul></ul>Claim Submission- cont’d .
    22. 22. <ul><li>To confirm whether your quarterly claim has been successfully submitted to the on-line system: </li></ul><ul><ul><li>Select the Create a Report function from the main menu </li></ul></ul><ul><ul><li>Select Print a Medicaid Administration Claim </li></ul></ul><ul><ul><li>Select a claim period </li></ul></ul><ul><ul><li>Claim has been submitted if a name appears in both the matching fund certification and attestation of accuracy. </li></ul></ul>Claim Submission-cont’d.
    23. 23. Claim Reviews <ul><li>Why review?? </li></ul><ul><ul><li>Claims go through a review process at ODMRDD and ODJFS. In the future, audits will be performed as well. Findings will be issued against claims that contain errors or are not supportable. In such cases, the entity will be required to pay back the Federal reimbursement they have received for that claim. </li></ul></ul>
    24. 24. <ul><li>ODMRDD reviews revealed that incomplete time studies were approved and submitted in claims. </li></ul><ul><li>Descriptions of activities should clearly support the codes used and sufficiently explain the task performed for every 15 minute unit. </li></ul><ul><li>These are good topics to include in your quarterly training information. </li></ul>Claim Reviews- cont’d .
    25. 25. MAC Resources Online Help <ul><li>http://odmrdd.state.oh.us/counties/mac.htm </li></ul><ul><li>What’s available? </li></ul><ul><ul><li>Links to MAC PowerPoint presentations and other training materials </li></ul></ul><ul><ul><li>MAC IT Participant and Coordinator User Guides </li></ul></ul><ul><ul><li>Security affidavit for access to MAC online </li></ul></ul><ul><ul><li>Contact information </li></ul></ul>
    26. 26. <ul><li>Individual MAC Costs by Code report provides information for the annual county cost reports </li></ul><ul><li>To access this report: </li></ul><ul><ul><li>If needed, complete a security affidavit for access to CRN_MACReports_County_COG. </li></ul></ul><ul><ul><li>Click on the CRN button from the applications menu. </li></ul></ul><ul><ul><li>Choose Go to CRN ReportNet </li></ul></ul><ul><ul><li>Choose MAC (CountyCOG) </li></ul></ul><ul><ul><li>What other reports would help you? </li></ul></ul>MAC Resources Cognos Report Available
    27. 27. Reminders <ul><li>The deadline for next quarterly roster: </li></ul><ul><li>April 18 th </li></ul><ul><li>The next time study week: </li></ul><ul><li>May 3 – May 9 </li></ul><ul><li>Notify staff no earlier than: </li></ul><ul><ul><li>April 26 th </li></ul></ul>
    28. 28. <ul><li>On-line MAC system help: </li></ul><ul><ul><li>[email_address] </li></ul></ul><ul><li>Technical assistance with security affidavits: </li></ul><ul><ul><li>[email_address] </li></ul></ul>MAC Contacts
    29. 29. <ul><li>Jenny Jones </li></ul><ul><li>ODMRDD MAC Coordinator </li></ul><ul><li>[email_address] </li></ul><ul><li>Phone: 614-644-7028 </li></ul><ul><li>Division of Fiscal Administration </li></ul><ul><li>Rhodes State Office Tower </li></ul><ul><li>30 E. Broad Street, 13 th Flr </li></ul><ul><li>Columbus, Ohio 43215 </li></ul>MAC Contacts
    30. 30. Final Thoughts <ul><li>Questions ?? </li></ul><ul><li>Feedback ?? </li></ul><ul><li>Good-bye! </li></ul>

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