2017 Annual MAA/TCM Conference CMAA Invoice 2017 Annual MAA/TCM Conference 1

Pat Ericsson, Santa Clara County Nancy Leidelmeijer, NLeader Group Presented by Pat Ericsson, Santa Clara County Nancy Leidelmeijer, NLeader Group 2

OBJECTIVES Ensure accurate MAA invoices Timely processing and payment of invoices Avoid disallowances

Purpose of MAA Invoice To determine the actual costs of providing MAA services To determine the federal reimbursement amount (FFP)

Computation of Federal Claim Adjusted cost pools (after revenue offset) Percentage of time survey activities Federal Financial Participation (FFP) Rate Federal reimbursement A x B x C = D

Summary of Steps Read MAA Invoice instructions Gather the required data and documents Analyze costs and funding sources Develop supporting documentation Enter data in invoice template

Claiming plan functions grid Time survey results percentages Data to gather Claiming plan functions grid Time survey results percentages Labor and services and supplies costs Indirect/overhead expenses

Discount methodology percentages Data to gather Discount methodology percentages Direct charged expenses Funding sources

Categorizing expenses 6 Cost Pool categories: CP 1 - SPMP CP 2 - Non-SPMP CP 3a - Non-Claimable CP 3b - Non-Claimable direct charge CP 4 - SPMP direct charge CP 5 - Non-SPMP direct charge CP 6 - Allocated costs 9

Cost Pool 1 Skilled Professional Medical Personnel (SPMP) who participated in the time survey Clerical staff who are supervised by SPMP and who provide direct support to the SPMP Supervisors of the SPMP 10

Cost Pool 2 All Non-SPMP staff who participated in the time survey Clerical staff who work for Non-SPMPs Supervisors of the Non-SPMPs Supervisors of clerical staff who directly support Non-SPMPs Personal services contractors who participated in the time survey 11

Cost Pool 3a Staff who did not time survey and are not included in other cost pools or direct charged Staff who exclusively provide treatment, counseling, clinical services, lab services or other non-claimable activities of the claiming unit 12

Cost Pools 3b, 4, and 5 These totals are automatically transferred from other worksheets in the invoice template 13

Cost Pool 6 General or administrative staff who: Did not participate in the time survey Costs have not been direct charged Support the staff in the other cost pools Costs are not included in any indirect rate computation 14

Questions?

Developing Supporting Documentation

Time survey results Separate time surveys by SPMP and non-SPMP Total the hours by activity code Analyze time surveys

Labor Detail Separate the amount for salaries and benefits SPMP staff from time survey percentages (and supervisors and support) Non-SPMP staff from time survey percentages (and supervisors and support) Non-claimable Direct Charge Allocated general and admin support staff 18

Other Costs Normal day-to-day operating expenses necessary to run the claiming unit See PPL 09-003 Indirect costs, external and/or internal NOTE : Any labor costs included in indirect must be excluded from other cost pools 19

Other Costs CP 1 - SPMP CP 2 - Non-SPMP Expenses that can be attributed to SPMP staff Overhead/Indirect expenses CP 2 - Non-SPMP Expenses that can be attributed to Non- SPMP staff Overhead/Indirect expenses

Other Costs Cost Pool 3 Costs that can be attributed to non-claimable staff Unallowable costs associated with direct service Overhead/Indirect expenses

Other Costs Cost Pool 5 Expenses that can be directly charged to MAA MAA specific contracted costs Overhead/Indirect expenses

Other Costs Cost Pool 6 Expenses that can be attributed to allocated staff General office expenses Building maintenance expenses Utilities Overhead/Indirect Expenses

Other Costs Identify other costs and develop backup document showing detail and amount to be claimed For costs labeled, “Special,” “Other,” “Departmental,” provide description

Direct Charged Expenses MAA Coordination and claim admin Any 1 reimbursable MAA activity code LGA consortium participation fee Direct MAA expenses: Travel and transportation Flyers and brochures Subcontractors/consultants

Questions?

Revenues Worksheet Purpose: To offset funding against costs to arrive at the net cost in which the federal government will share and to list CPE.

Revenues Worksheet Analyze all funding sources Determine allocation methodology for offset to avoid double dipping Determine public funds eligible to use as CPE 28

What to Offset? All federal funds, including Maintenance of Effort (MOE) and match funding All state general funds that have been previously matched by the federal government including Medi-Cal fee for service funds Insurance collected from non-governmental sources for the delivery of direct client services

What Not to Offset? County General Funds Realignment Funds Other Local Funds (First 5) MAA Reimbursements

Revenues Worksheet Medi-Cal Fees and Match Federal Grants and Match State General Funds Medicare Insurance Fees Other Revenue 31

Revenue Sources Summarize your revenues quarterly Annual revenues may be divided equally into each of the 4 quarters

Revenues Worksheet Revenues are categorized as follows: Not Offset Funds CP 1 - SPMP CP 2 - Non-SPMP CP 3a&b - Non-Claimable CP 4 - Direct-Enhanced CP 5 - Direct-Non-Enhanced CP 6 - Allocated 33

Medi-Cal Discount Percentage Actual Client Count (ACC) or Countywide Average ACC - calculate percentage and compile documentation showing the percentage for that quarter Compile the eligibility verification used in the ACC

Supporting Documents for Other Costs and CP6 Employees All invoices require the submittal of supporting documents for other costs every quarter: Include list of classifications for the reported salaries and benefits of CP6 Include a list of other costs associated with the costs in CP1, CP2, and CP6

The CMAA Invoice Template Summary page TCM time survey results Revenue worksheet Invoice cost worksheet Direct charges worksheet Invoice claim calculation worksheet Variance worksheet

Checklist For Preparing the MAA Detail Invoice CMAA CHECKLISTS Checklist For Preparing the MAA Detail Invoice Checklist For Preparing the MAA Summary Invoice

PACKAGING YOUR INVOICE Cover Letter (on LGA letterhead) MAA Invoice template Include checklists For MAA Detail Invoice For MAA Summary Other costs detail and staff classification for CP6 and other documentation when requested

Resources Department of Health Care Services website www.dhcs.ca.gov/ProvGovPart/Pages/CMAA.aspx LGA Consortium website www.MAA-tcm.com

Questions?

Thank you for your attendance!! 41