jonathan alspektor, bsbamary wieg, phn, mba contract managerprogram consultant

Jonathan Alspektor, BSBA Mary Wieg, PHN, MBA Contract Manager Program Consultant

Jan Campbell, BSN, PHNMCAH DirectorSan Luis Obispo

Understand:

Federal Financial Participation (FFP) is a Title XIX (Medicaid) program that allows states to receive

partial reimbursement for activities that meet FFP objectives.

FFP has two programs:1.) Targeted Case Management – TCM2.) Medi-Cal Administrative Activities – MAA

MAA FFP reimburses for activities that primarily involve linking clients to Medi-Cal services and/or coverage. MCAH-FFP is a MAA program

MCAH FFP is a MAA program.

To assist individuals eligible for Medi-Cal to enroll in the Medi-Cal program and/or

To assist individuals on Medi-Cal to access Medi-Cal providers, care and services.

The MCAH program and staff must meet all FFP requirements to be reimbursed with Title XIX funds.

The local program must use qualifying non-federal funds (i.e. local county/city/state funds) to draw down Title XIX matching/reimbursement.

Only activities that meet the FFP Objectives may be reimbursed.

75/25 Enhanced Matching (SPMP)

$1 spent = .75 cents reimbursed

50/50 Non-Enhanced Matching (Non-SPMP)

$1 spent = .50 cents reimbursed

There are two FFP personnel classifications:

1.) Skilled Professional Medical Personnel (SPMP)

Education and training at the professional level (SPMP Questionnaire)

2.) Non-Skilled Professional Medical Personnel (Non-SPMP)

All other personnel

Staff must track 100% of their time for activities for all programs worked for a minimum of one month each quarter. (This includes non-MCAH programs).

The “start and stop” time of all activities are required on all time studies and secondary documentation.

SPMP Questionnaire:Assure that all SPMPs have completed the document

Keep all SPMP Questionnaires on file

FFP Time Studies:Provide & oversee FFP training for your MCAH staff

Review all staff FFP Time Studies & secondary documentation for completeness and accuracy

1. Is this activity in the MCAH, BIH, or AFLP Scope of Work?

Yes, continue

No, code to Other Programs

2. Does this activity meet the objectives in the FFP Guidelines?

Yes, continue

No, code to Code 11

3. Does this activity require the skill, knowledge, and expertise of an SPMP?

Yes, code to 2,3,6,8, or 9

No, code to 1,4,5, or 7

2: Administrative Medical Case Management

(Short Term Only)

3: SPMP Intra/Interagency Coordination, Collaboration and Administration

6: SPMP Training

8: Program Planning and Policy Development

9: Quality Management

1: Outreach

4: Intra/Interagency Collaboration and Coordination

5: Program Specific Administration

7: Non-SPMP Training

Code 11 is Other MCAH Scope of Work Activities that are not matched

Codes 10 and 12 are allocated rates:

10: Non-Program Specific General Administration (such as agency-required meeting, training, or

staff development).

12 : Paid Time Off

Must maintain supplemental (secondary) documentation to support information recorded on the Time Study.

Examples:

Daily logs, appointment books, calendars, meeting agendas, minutes

Documentation must be explicit enough to support function code used

Example: Teen Pregnancy and Parenting collaborative

meeting, discussed poor access to prenatal care for teen moms in north county.