California School Based Medi-Cal Administrative Activities (MAA)

June 11, 2012

RANDOM MOMENT UPDATE

The LEC formed a subcommittee to draft a Random Moment Time Survey plan to submit to the Department of Health Care Services (DHCS). The draft was submitted to DHCS on 8/17/11. As of now, the state will not be using that plan and they are working on their own plan.

TIME SURVEY NOTES

The first time survey period for the 12/13 school year begins on September 17, 2012.

As a reminder, beginning in 11/12, the time survey samples are required to state the Medi-Cal service/s. Samples with only "Medi-Cal covered service" will not be accepted. Samples with just "health service" are also not acceptable.

Your time survey results for 11/12 should be complete and submitted to your vendor. Region 8 LEC reviews all time survey results to determine reasonableness.

AUDITS

California was recently the subject of an audit from the federal oversight agency Centers for Medicaid and Medicare Services (CMS). CMS selected 3 claiming units to review, one in Region 8 and subsequently requested information for an additional 16 claiming units in California for audit. We do not yet know the results of the CMS audit.

The Office of Inspector General (OIG) has also selected California to perform an audit of the MAA program. The OIG is the auditing agency for the U.S. Department of Health and Human Services (HHS) (CMS is in their department). OIG’s responsibility is to protect the integrity of HHS programs and operations by detecting and preventing fraud, waste, and abuse; identifying opportunities to improve program economy, efficiency and effectiveness and holding those accountable who do not meet program requirements.

We will keep you updated as to the progress of both the CMS and OIG audits.

May 17, 2011

The Medi-Cal Administrative Activities (MAA) program may be going through another evolution. For those veterans of the program, you know we went through a significant change in 2003-2004. The proposed change would streamline the time survey process for the participants and reduce the administrative burden on the district.

Some of you may have heard of the new and simpler method for the time survey process- the Random Moment Time Survey (RMTS). RMTS is designed to make it much easier and faster for participants to submit time data related to MAA. RMTS requires that participants submit brief descriptions of the activities they are performing at randomly selected moments throughout the quarter. In any given quarter, some employees will be selected for more moments then others, and some may not be selected at all. When the employee is notified of their random moment, they will record (electronically) who they were with, what they were doing, and why they were doing it. The employee no longer needs to code the activity; the coding will be handled by others.

Though RMTS operates continuously, it is seen by most as far less intrusive than the current methodology as the moments are only in one-minute increments, allowing staff to spend much more time focusing on other duties.

The federal government (CMS) has recently approved the use of RMTS for the Los Angeles Unified School District. We want to make RMTS available to every California district.

The LEC has created a subcommittee that has begun taking the necessary steps in making RMTS available to all districts. Because the changes to the program will be significant, we would like to make you aware that multi-year contracts may be in contrast to future program operations.

We will periodically update you on our progress.

If you have any questions, please do not hesitate to contact me at maroux@kern.org or 661-636-4769.

March 2, 2010
Region 8 LEC

LEA Medi-Cal Billing and Free Care Regulations
Although we are not the oversight agency for the LEA Medi-Cal billing program, we often do field questions from districts and offer assistance when we can. As a courtesy to you, we would like to address a regulation titled "free care", which was set forth by Centers for Medicaid and Medicare Services (CMS), the federal oversight agency. We understand that some districts may be incorrectly billing for unallowable (non-IEP) medical services.The free care and other health coverage regulations virtually eliminate the ability of districts to bill for medical services for non-IEP students. As we understand it, districts are very unlikely to meet the guidelines put forth by CMS as the stipulations make it almost impossible to comply. Please contact DHCS at lea@dhcs.ca.gov if you have any questions or concerns surrounding billing of medical services for non-IEP students.

Too Good to be True???
We understand that districts have been contacted regarding the LEA and MAA programs and some lofty projections have been made about how much revenue that districts are supposedly leaving on the table. Please keep in mind, if it sounds too good to be true, it likely is too good to be true. If you have any concerns regarding this issue, please feel free to contact us.

MAA Site Reviews
Another round of site reviews have been completed. Most were without problems! We have only one comment-please include in your audit binder a copy of any medical and/or Medi-Cal related materials that are specific to your district or area. The materials can pertain to any period during the school year. Examples are: agendas for meetings that include medical topics, listing of medical providers who accept Medi-Cal in your area, district specific medical referral forms and/or a listing of what medical services your district provides.Samples and Web-Based Time Survey FormsAs a reminder, all of the samples should be written or typed by the participant only. If your district uses a web-based time survey form, there should be no auto-fill feature or anything that offers the participant wording suggestions.

ARRA (Stimulus) Funds
Remember that MAA participants cannot be paid with federal funds. Take precaution to ensure that the ARRA funds are not used to pay for your participants, as it will disqualify them from inclusion in the invoice.

Overall
Thank you very much for your cooperation and participation in the MAA program. Should you have any questions, please do not hesitate contact myself or Ken Gragg at kegragg@kern.org.

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