maa News

KCSOS Webteam

August 11, 2009

Agenda Items for MAA Coordinators Meeting

(Please note that 4 separate meetings were conducted and not all items were discussed at each location)

·        Rescission of CMS 2287 P-2-

·        At this time there are no pending regulations to eliminate the program. However, there is still pending a mandated report to Congress (contract no: HHSM-500-2005-00024). There is still an ongoing effort to "fix" the program.

·        The rule (2287 P-2) does state that CMS has tools at its disposal to address inappropriate claiming.

·        Audit findings-

·        LEC site reviews-Reviews were done in March. Most issues were clerical in nature and easily resolved. Please be sure time surveys are signed prior to submission of the invoice.

·        DHCS site reviews-Performed in April-DHCS stated that we would receive the official results in 60-90 days. We have yet to receive official results. DHCS did conduct exit interviews with the LEC and districts that were reviewed. Some of the items discussed were:

Code 15 and 16 were excessive

Identical handwriting found on multiple surveys

Participants signatures were not found on training roster

Erasures and corrections were not initialed

Samples were not coded correctly

Samples for services not Medi-Cal reimbursable

Samples were not Medi-Cal specific

Other Items-

·        It is not a DHCS mandated requirement to use specific dates in samples. Region 8 strongly recommends against this practice.

·        Coordinators should not have access to change a participant's time log or samples.

·        Identical samples (verbiage) and like handwriting has been observed. Please have participants write/type things in their own words. Only the participant should be writing (or entering) samples and time on their survey.

·        District responsibility versus vendor responsibility was discussed. Any disallowance, error or omission is the responsibility of the district. The LEC does not contract with vendors, nor can we hold them responsible.

·        Little MAA time-Those participants who consistently have less than 1 hour of MAA reimbursable time quarter after quarter should not be included in the invoice. The MAA Coordinator should make the determination and watch patterns regarding too little MAA reimbursable time.

·        Samples for PTO-should not be specific to type of leave, should only read "XX hours of paid time off."

·        Code 15 should reflect the amount of time the MAA participant devotes to completing the time survey form. We understand that there are days when it may take more than a quarter hour to properly account for his or her time; however, there are also days when little time is spent on time accounting activities. All time survey participants must be reasonable in their approach when recording time. Activities should not be performed during MAA week to enhance time in any particular code.

·        KCSOS' time frames for submission of invoices and time survey results:

·        Time survey results should be finalized within 3-4 months of the end of the time survey period. This helps pinpoint and correct any issues before 3 or 4 quarters have passed.

o The invoices are due as follows (due 13 months after the end of the time survey quarter):

1st quarter: October 31st

2nd quarter: January 30th

3rd quarter: April 30th

4th quarter: July 31^st

·        Upcoming site reviews- If your district has not been reviewed in the past 3 years, it is likely that a review will be scheduled sometime this fiscal year. 30-45 days notice will be given to the district and vendor.

·        Ways to maximize reimbursement was discussed:

·        Watch vendor fees as a percentage of the overall reimbursement

·        Increase # of eligible/legitimate participants

·        Get support from administration

·        Provide incentives

·        Hold participants accountable and give plenty of program support

·        Be sure to work with the business department regarding funding; specifically the stimulus funds as they are federal dollars.

·        The MAA website has been updated with the status of each MAA invoice and the LEC minutes are current. The website address is: http://kcsos.kern.org/maa/

August 8, 2009

The 09/10, second quarter time survey period begins on Saturday, October 17, 2009. Since I am not aware of any K-12 school in the United States that is in session on a Saturday, you will begin your survey on the following Monday.

June 30, 2009

Please click below for information regarding the MAA Coordinator meetings:

MAA Coordinators Meeting Information

June 30, 2009

HHS RESCINDS MEDICAID REGULATIONS

Department of Health and Human Services (HHS) Secretary Kathleen Sebelius today announced that the administration will rescind all or part of three Medicaid regulations that were previously issued and delay the enforcement of a fourth regulation. Each of these rules, in whole or in part, had been subject to Congressional moratoria set to expire on July 1, 2009.

"These regulations, if left in place would have potentially adverse consequences for Medicaid beneficiaries, some of our nation's most vulnerable people; said Secretary Sebelius. "By rescinding these rules, we can expect that children will continue receiving services through their schools, beneficiaries will be able to access all available case management resources to help them better manage their health care, and outpatient hospital and clinic services can continue to be covered in the most efficient manner;

"The actions we are taking today are necessary to ensure that the states have the flexibility they need to fully serve Medicaid-eligible individuals; said Secretary Sebelius.

The Centers for Medicare & Medicaid Services (CMS) and HHS today are:

·     Rescinding a final rule, published December 28, 2007, that would have eliminated reimbursement for school-based administrative costs and costs of transportation to and from schools. The rescission reflects concern that the rule could limit the Medicaid administrative outreach activities of schools, and that the overall budgetary impact on schools could potentially impact their ability to offer Medicaid services to students.

·     Rescinding provisions of an interim final rule published December 4, 2007, which would have restricted beneficiary access to case management services. These provisions appeared to, in practice, restrict beneficiary access to needed covered case management services, and limit state flexibility in determining efficient and effective delivery systems for case management services.

May 12, 2009

09/10 First Quarter Time Survey Period

DHCS has announced the 09/10, 1st quarter time survey period. It begins on Saturday (yes, Saturday) August 22nd. I am confident that your district will have to coordinate a different start date as no students should be in attendance on Saturday. Some districts/schools will still be on summer recess or just beginning the school year. Please work with myself or your vendor to make sure that your district will start on the appropriate date. Please be sure to include the district calendar and an explanation in your audit file if your district does not begin on the DHCS prescribed time survey period.