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Health & Human Services

Local Health Department/District

Medicaid Administrative Claiming (MAC)

Overview

Welcome to the

The Purpose of MACTo provide Local Health Department (LHD’s)

the opportunity to submit reimbursement claims for administrative activities that support the Medicaid program such as: Medicaid Outreach Medicaid Referral, Coordination, and Monitoring Medicaid Transportation and Translation Medicaid Provider Relations

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The Benefits of MACGenerate Revenue from MAC claim

submission

Dedicated to the provision of health services

May be used to enhance services at the LHD’s by improving and/or expand the level and quality of

health/medical services provided to clients within the community

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MAC Process

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Determine who performs MAC

activities

Determine who performs MAC

activities

Determine how much

reimbursable activity is performed

Determine how much

reimbursable activity is performed

Determine actual costs

associated with these activities

Determine actual costs

associated with these activities

Apply reimbursement rates (TS, MER,

IDCR) to calculate a claim

Apply reimbursement rates (TS, MER,

IDCR) to calculate a claim

Participant ListParticipant

Identification

Participant ListParticipant

Identification

Random Moment Time Study

Random Moment Time Study

MAC Financial Data CollectionMAC Financial Data Collection

MAC Claim CalculationMAC Claim Calculation

How to get started in MACInteragency Agreement

Direct Deposit Form

Vendor Information Form

Payee Number Application

http://www.hhsc.state.tx.us/rad/mac/mac-contracting.shtml

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MAC Financial Contact Responsibilities

Serve as financial liaison between HHSC & Fairbanks LLC Must attend MAC Financial Training at a minimum

annually Enter, verify and certify the MAC financial data on the

system Certify, notarize and submit quarterly MAC financial

reports Maintain financial documentation and supporting materials Must be listed as the primary MAC Financial Contact Trained Financial Contacts must maintain the accuracy of

ALL Contacts in the cost reporting system

What Cost can I report?• Compensation

Entity Employee Salaries Payroll Taxes & Benefits

Only Report “True” Expenditures If your entity sets funds aside for future Workers

Comp claims then these “set aside” funds are not true expenditures.

Contracted staff

• Revenues (Federal Revenues offset expenditures)

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Mr. Higgins, CPA

Functional Reporting

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There are two options to enter financial data:

1. Participant Detail (Preferred) • Detailed basis by individual position

2. Group Summary• Provider category summary

• Categories as entered on the participant list

• If your entities enters at this level, they must keep the detail by position/individual in the audit documentation file.

Detailed Worksheet

Psychologists and Interns

Bob Employee

Joe Employee

Mary Contract Staff

Registered Nurse (RN)

Salaries 30,000

Benefits 6,000

Purchased Svcs. 8,000

Category Summary

MAC Financial Reporting MAC financial quarters will not be opened

unless the following requirement are met:

Active contract with HHSC Appropriate MAC & RMTS training for the FFY RMTS Requirements are met

If you are unable to access the quarter, please contact the MAC team via email at:

MAC@hhsc.state.tx.us

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Important Notice LHDs participating in MAC

Please be aware that costs associated with MAC activity and claimed on the MAC claim may not be included as part of the cost report submitted for reimbursement under the Texas Healthcare Transformation and Quality Improvement 1115 Waiver Program.

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Time Study PeriodsFederal Fiscal Quarters

1st Quarter - October, November, December

2nd Quarter - January, February, March3rd Quarter - April, May, June4th Quarter - July, August, September

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Important Dates for MAC Claim Submission

Date Event Description Open Date Close Date1st Quarter MAC Financials 02/18/2013 04/05/20132nd Quarter MAC Financials 05/27/2013 07/12/2013

3rd Quarter MAC Financials 08/19/2013 10/04/2013

4th Quarter MAC Financials 11/25/2013 01/10/2014

All important information, notices, claim due dates, etc can be found on the

following website: http://www.hhsc.state.tx.us/rad/mac/mac-lhd.shtml

This information along with additional updates may also be found on the Dashboard page of STAIRS web system.

Contacts Medicaid Administrative Claiming – (512) 491-

1802 – MAC@hhsc.state.tx.us (MAC Email Box) http://www.hhsc.state.tx.us/rad/mac/index.shtml (MAC Website)

Yvonne Moorad - Team LeadSandra Brabandt - LHDs

STAIRS (State of Texas Automated Reporting System) & Website Questions – info@fairbanksllc.com

Fairbanks Hotline: (888) 321-1225

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