LGAConf 2019 CMAA HOT TOPICS BY Debbie Daniel

LGAConf 2019 CMAA HOT TOPICS BY: Debbie Daniel, LGA Coordinator Nevada County

DISCLAIMER: � � The information provided is for informational purposes only and is not intended to substitute for obtaining CMAA and TCM information from your Local Government Agency (LGA) coordinator and/or California Department of Health Care Services. Presentation of the information is not intended to create and constitute a vendorclient relationship. All participants to this conference are advised not to act upon this information without seeking the service of your LGA Coordinator and/or California Department of Health Care Services. Any advice contained in the conference materials or from presenters in this conference is not intended to be used for the purpose of meeting compliance under Federal and/or State laws and regulations. The views and opinions of the presenters and materials expressed herein do not necessarily state or reflect those of California Department of Health Care Services or LGA. While we use reasonable efforts to furnish accurate and up-to-date information, we do not warrant that any information contained in or made available through this conference is accurate, complete, reliable, current or error free. We assume no liability or responsibility for the accuracy, completeness or usefulness of any information disclosed in the presentation and conference materials.

AGENDA � Codes 6 & 10: Non-Medical Transportation � CMAA Tape Match Update – MOVEit � PPL 18 -012 R: Multiple Medi-Cal Discount Percentage Methodology � PPL 19 -001: CMAA Invoice Support Documentation Requirements � PPL 19 -002: Revised CMAA Invoice Checklist � CMAA Guidelines Work Group Project � Time Survey Training

Code 10 -Arranging And/Or Providing Transportation to a Medi-Cal Covered Service § § Managed Care entities are receiving funding for providing transportation services to managed care clients. To ensure there is no duplication of payment, Code 10 can no longer be used for transportation services for Medi-Cal Managed Care Plan enrollees. Claiming units may claim costs under code 6 for referring, coordinating, and monitoring transportation services provided to all beneficiaries. § Revised Code 6 Activity Statements were due to DHCS on 3/22/19 to include this activity.

Tape Match – MOVEit Software § LGAs can access software as of 7/1/19 to verify Medi-Cal status of clients. § Requires Client Name, Date of Birth, & Social Security Number § § If interested, counties should request access from DHCS – no requirement to use software. Generally, using an Actual Client Count rather than County-Wide Average improves CMAA reimbursements

Multiple Medi-Cal Discount Percentage Methodology PPL 18 -012 R § § CMS approved the use of multiple Medi-Cal discount percentages starting July 1, 2017 for Codes 6, 10, 13, 17, and 18. Claiming units are required to use Actual Client Count (ACC) when possible. � Claiming units may use both the County-Wide Average (CWA) and ACC within a single invoice.

Multiple Medi-Cal Discount Percentage Cont. PPL 18 -012 R � All LGAs need to submit justification packets to DHCS annually, before the fiscal year ends on June 30. ◦ Justification packets include justification letter (on county letterhead) and copies of activity statements. Letter must include: � How the claiming unit is able to develop Multiple Medi-Cal Percentages per claiming unit and/or activity � Any internal procedures/mechanisms in place to record client data and how that information will be separated by activity � The intended methodology to be utilized, per activity code (i. e. , CWA and/or ACC) � Identify sources used to collect and/or confirm the client data for developing the Medi-Cal discount percentage for each code � Identify the programs and individually list the specific populations served for claiming units that serve multiple programs and/or populations ◦ Justification letters required even if just using the CWA.

CMAA Invoice Support Documentation Requirements PPL 19 -001 For all invoices submitted after January 2, 2019, DHCS is requiring supporting documentation submissions for Cost Pools 1, 2, 4, 5, and 6 with each invoice. � The documentation must include: § ◦ Organization charts to demonstrate the relationships between CMAA participants and their support and/or supervisors. ◦ Detailed lists of all staff names in each cost pool, classifications, and the salaries and benefits claimed.

Example of Supporting Documentation Cost Pools 1 -6 Invoice Submission Salary and Benefits Support Documentation FY: 18/19 Q 2 SALARY TABLE Staff Names Salaries Claimed First Name BUGS SCOOBY MICKEY MINNIE HOMER BART DONALD DAFFY Last Name BUNNY DOO MOUSE SIMPSON DUCK JERRY CHARLIE FRED WILE MOUSE BROWN FLINTSTONE COYOTE Classification Physical/Occupational Therapist Senior Public Health Nurse Director - Public Health Education Coordinator Project Coordinator Clinic Practitioner Administrative Analyst Senior Administrative Analyst Assistant Physical/Occupational Therapist Health Education Coordinator Health Technician Public Health Nurse LINUS MIGHTY LISA VANPELT MOUSE SIMPSON Administrative Assistant Project Coordinator Epidemiologist MARGE SIMPSON Subtotal Director Public Health Nursing BETTY TWEETY BOOP BIRD Health Technician Senior Health Technician Permanent 21, 562. 35 23, 786. 19 41, 727. 63 14, 109. 77 14, 320. 16 0. 00 19, 581. 64 0. 00 CP 1 Temporary 0. 00 1, 702. 53 0. 00 6, 549. 32 CP 6 Allocated Costs SPMP Non-Claimable 21, 562. 35 23, 786. 19 41, 727. 63 14, 109. 77 14, 320. 16 1, 702. 53 19, 581. 64 6, 549. 32 16, 008. 97 19, 581. 64 12, 562. 28 0. 00 16, 008. 97 14, 662. 78 0. 00 26, 020. 42 0. 00 3, 739. 32 0. 00 14, 662. 78 33, 652. 34 283, 343. 22 0. 00 11, 991. 17 12, 562. 29 13, 204. 76 Cost Pools CP 2 CP 3 0. 00 19, 581. 64 12, 562. 28 12, 562. 29 13, 204. 76 Y Y Y N 0. 00 Y Y N 3, 739. 32 26, 020. 42 33, 652. 34 109, 672. 63 183, 959. 23 TIMESTUDY PARTICIPANT Relationship N Supervises Jerry Mouse (CP 1) Y Y N Y Y 1, 702. 53 0. 00 Y Supports Marge Simpson (CP 1) Supervises Linus Van. Pelt (CP 1)

Example of Supporting Documentation Continued BENEFITS TABLE Staff Names CP 1 First Name Last Name Classification BUGS SCOOBY MICKEY MINNIE HOMER BART DONALD DAFFY BUNNY DOO MOUSE SIMPSON DUCK JERRY CHARLIE FRED WILE BETTY TWEETY MOUSE BROWN FLINTSTONE COYOTE BOOP BIRD Physical/Occupational Therapist Senior Public Health Nurse Director - Public Health Education Coordinator Project Coordinator Clinic Practitioner Administrative Analyst Senior Administrative Analyst Assistant Physical/Occupational Therapist Health Education Coordinator Health Technician Public Health Nurse Health Technician Senior Health Technician LINUS MIGHTY LISA VANPELT MOUSE SIMPSON Administrative Assistant Project Coordinator Epidemiologist MARGE SIMPSON Subtotal Director Public Health Nursing TOTAL PERSONNEL Benefits Claimed SPMP 13, 519. 99 14, 010. 86 19, 753. 22 11, 521. 32 7, 047. 20 147. 24 9, 087. 08 583. 88 13, 519. 99 14, 010. 86 10, 891. 64 13, 603. 81 10, 748. 42 0. 00 9, 298. 88 9, 647. 59 10, 891. 64 8, 495. 02 323. 43 9, 107. 58 8, 495. 02 11, 535. 41 159, 322. 57 5, 767. 71 61, 792. 80 454, 656. 96 Cost Pools CP 2 CP 3 Non SPMP 19, 753. 22 11, 521. 32 7, 047. 20 9, 087. 08 583. 88 13, 603. 81 10, 748. 42 9, 298. 88 9, 647. 59 CP 6 Non-Claimable Allocated Costs TIMESTUDY PARTICIPANT N Y Y 147. 24 Y Y Y N Y Y 0. 00 323. 43 N Y N 5, 767. 71 97, 382. 54 147. 24 0. 00 Y 171, 465. 43 281, 341. 77 1, 849. 77 - 9, 107. 58 Relationship Supervises Jerry Mouse (CP 1) Supports Marge Simpson (CP 1) Supervises Linus Van. Pelt (CP 1)

Revised CMAA Invoice Checklist PPL 19 -002 § § § DHCS revised the CMAA Invoice Checklist for all invoices submitted after January 2, 2019. The primary reason for revising the checklist is to update the supporting document requirements for Cost Pools 1, 2, 4, 5, and 6 (PPL 19 -001). Issues have been raised with DHCS regarding the first item: § “Approved Comprehensive Claiming Unit Grid and Claiming Unit Function Grid(s) on file; time survey frequency must match and ensure the “ 95 percent confidence level” requirement is met”

CMAA Guidelines Work Group Project § Submitted requested changes to the CMAA/TCM Implementation Plan to DHCS. Changes include: ◦ Update/modify the definition of Code 10 to comply with AB 2394 ◦ Update/amend language in the plan about time survey training requirements. ◦ Separate Non-Perpetual Time Survey (5, 10 and 20 day) requirements from Perpetual Time Survey requirements. ◦ Provide more detail regarding Direct Supervision and Direct Support so that LGAs can ensure they are complying with federal and state rules.

Time Survey Training § § § The current understanding is that once the LGA Coordinator and/or Alternate completed the Annual DHCS training, the LGA has the autonomy to choose how their participants are being trained. LGAs are ultimately responsible in making sure that time survey participants are appropriately trained. This continues to be a hot topic § LGA Coordinator or Alternate must attend DHCS’s Annual Time Survey Training (webinar)

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