Quarterly MAC Financial Data Submission Training Presented to: West - PDF document

Public Consulting Group 10/15/2012 Quarterly MAC Financial Data Submission Training Presented to: West Virginia Association of School Business Officials Presented by: Public Consulting Group, Inc. October 18, 2012 www.publicconsultinggroup.com Outline • Medicaid and WV Medicaid Administrative Claiming (MAC) • MAC Participation Requirements • Claiming Allowable Costs • Calculating the Claim • Web-Based Reporting System (Medicaid Cost Reporting and Claiming System—MCRCS) • Quarterly Financial Submission • Second Quarter Pilot RMTS Results • Important Dates and Contact Information West Virginia ASBO Conference www.publicconsultinggroup.com 1

Public Consulting Group 10/15/2012 Medicaid and WV Medicaid Administrative Claiming (MAC) West Virginia ASBO Conference Schools and Medicaid • Schools provide an array of health-related (medical) services in addition to traditional “educational services” to ensure that students are able to fully participate in the school environment. • These direct medical services form the basis for the West Virginia Department of Health and Human Resources, Bureau for Medical Services (DHHR/BMS) Medicaid Fee-for-Service (FFS) program. • School staff are uniquely positioned to assist in enrollment of eligible students in Medicaid, to assist them in receiving the medical services and supporting administrative services they require, and to provide medically- necessary services . • These administrative services form the basis for Medicaid Administrative Claiming (MAC). West Virginia ASBO Conference www.publicconsultinggroup.com 2

Public Consulting Group 10/15/2012 What is the Medicaid Administrative Claiming Program? • The Medicaid Administrative Claiming (MAC) Program offers reimbursement for the costs of the administrative activities, such as outreach, that support the DHHR/BMS program. • These activities fall into several categories: • Medicaid Outreach • Facilitating Medicaid Eligibility Determination • Transportation Related to Medicaid Services • Translation Related to Medicaid Services • Program Planning, Policy Development, and Interagency Coordination Related to Medicaid Services • Medicaid-Related Training • Referral, Coordination and Monitoring of Medicaid Services West Virginia ASBO Conference Claiming Allowable Costs West Virginia ASBO Conference www.publicconsultinggroup.com 3

Public Consulting Group 10/15/2012 Allowable Costs • Only costs incurred by providers are allowable • Report only those costs associated with specific individuals participating in the RMTS program (i.e. how much does it cost to employ each staff person) • Allowable Costs • Salaries • Benefits • Materials & Supplies • Travel & Training • Contracted Staff Costs • Dues & Fees West Virginia ASBO Conference Allowable Costs • Allowable Costs • Salaries • Include all costs paid (gross) to the participant including any additional compensation • Employee Benefits • Include all benefits paid to staff. Some examples include • Dental Insurance • Health and Accident Insurance • Life Insurance • Long-term Disability Insurance • FICA • Medicare • Tuition Reimbursement • Worker’s Compensation • Teachers Retirement or Other Retirement Payments West Virginia ASBO Conference www.publicconsultinggroup.com 4

Public Consulting Group 10/15/2012 Allowable Costs • Materials & Supplies • Materials & Supplies must be identified as used by the staff for which they are included • Materials & Supplies can be identified using a “reasonable allocation method” • Some methods include – headcount or FTE • Please do not include any other costs used by direct medical service providers to deliver services to each individual student. Report direct medical other costs when the Medicaid Cost Report is available for submission in Fall 2013. West Virginia ASBO Conference Allowable Costs • Staff Travel • Costs for specific staff related to travel for trainings • Examples include: • Mileage to trainings • Conference related travel expenses • Staff Professional Dues and Fees • Report by service the total costs for professional dues and fees associated with the staff listed in the Quarterly Financial Report. West Virginia ASBO Conference www.publicconsultinggroup.com 5

Public Consulting Group 10/15/2012 Allowable Costs • Pending final approval, CMS has requested that costs be reported using the cash and accrual basis. PCG requires quarterly costs be submitted using the cash basis method of accounting for quarterly expenditure reporting and accrual for annual cost reporting. • Cost reporting by providers should be consistent with generally accepted accounting principles (GAAP), which are those principles approved by the American Institute of Certified Public Accountants (AICPA). • Reported costs in this section should be formatted with two decimal places and not rounded to the nearest whole dollar. • Reported paid hours should be formatted with two decimal places and not rounded to the nearest whole hour. West Virginia ASBO Conference Non-Allowable Costs • Non-allowable costs include: • Federal funds • The web-based system requires that total costs be reported, with a separate column for reporting costs paid with Federal funds. The system calculates the Medicaid-allowable costs. • State flow-through funds are funds received from the Federal government by the State of West Virginia and then distributed to Local Education Agencies (LEA) • Non-federal funds that have been committed as local match for other Federal or State funds or programs • Costs included in the calculation of the Unrestricted Indirect Cost Rate • Staff who are paid entirely from this area should not be included in the staff pool list. West Virginia ASBO Conference www.publicconsultinggroup.com 6

Public Consulting Group 10/15/2012 Calculating the Claim West Virginia ASBO Conference Calculating the Claim • The main components used to calculate a claim: • Random Moment Time Study Results (State) • Quarterly Expenditure Data (District) • Medicaid Eligibility Rates—MER (District) • Unrestricted Indirect Cost Rates—ICR (District) • Federal Financial Participation—FFP (State) • The claim is calculated by distributing the allowable costs and applying the above factors. • It is simple addition, subtraction, multiplication, and division . West Virginia ASBO Conference www.publicconsultinggroup.com 7

Public Consulting Group 10/15/2012 Calculating the MAC Claim West Virginia ASBO Conference Calculating the Claim through the Random Moment Time Study (RMTS) West Virginia ASBO Conference www.publicconsultinggroup.com 8

Public Consulting Group 10/15/2012 General Administration Overhead Factor Calculation • General Administration Code • Example Calculation • Codes 1,2, and 3 are Reimbursable • Code 3 is reduced by the MER • Code 4 is Non-reimbursable • Code 5 is the General Admin. Code for this example • MER = 20% T im e S t u d y P e r c e n t a g e C o d e 1 2 3 4 5 T o ta l 8 .6 1 % 1 0 .2 5 % 9 .4 3 % 5 3 .2 8 % 1 8 .4 4 % 1 0 0 % West Virginia ASBO Conference General Administration Overhead Factor Calculation T im e S t u d y P e r c e n t a g e C o d e 1 2 3 4 5 T o ta l 8 .6 1 % 1 0 .2 5 % 9 .4 3 % 5 3 .2 8 % 1 8 .4 4 % 1 0 0 % • Reimbursable % • Numerator (Sum of Reimbursable Time) = • Code 1 + Code 2 + (Code 3 X MER) • 9% + 10% + (9% X 20%) = 20.74% • Denominator = • 100% less General Administration • Note: Non-worked / Non-paid is not included • Code 1 + Code 2 + Code 3 + Code 4 • 100% - 18.44% = 81.56% • General Administrative Overhead Factor • = 21% / 82% = 25.43% West Virginia ASBO Conference www.publicconsultinggroup.com 9

Public Consulting Group 10/15/2012 Calculating the Claim West Virginia ASBO Conference Web-Based Reporting System West Virginia ASBO Conference www.publicconsultinggroup.com 10

Public Consulting Group 10/15/2012 Web-based Financial Reporting System Demonstration • Accessing the System • Navigating the System • Downloading Reporting Format • Uploading Data • Resolving System Audits • Certifying the Data • Managing Contacts West Virginia ASBO Conference Getting Started West Virginia ASBO Conference www.publicconsultinggroup.com 11

Public Consulting Group 10/15/2012 Logging In • To access the Medicaid Cost Reporting and Claiming System (MCRCS), open an internet browser and enter: https://costreporting.pcgus.com • The username is the submitted email address. Passwords will be sent to LEAs via email. Once logged in, the site users will be prompted to reset the password. If passwords are forgotten, simply click on ‘Forgot Password’ Link and a correct response to a security question will prompt the system to send a password to the user. West Virginia ASBO Conference Dashboard • Once logged in, the Dashboard displays. From this page it is possible to navigate through the screens. Also displayed are important dates, training information, and resources. Please check this page at every log in. West Virginia ASBO Conference www.publicconsultinggroup.com 12