CMAA Invoice Training - 2015

Presented by Nancy Leidelmeijer

805-216-6585

nleidel@healthreachconsulting.com

www.healthreachconsulting.com

TRAINING GOALS

•Ensure accurate MAA invoices

•Timely processing and payment

of invoices

•Avoid disallowances

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PURPOSE OF MAA INVOICE

•To determine the actual costs of

providing MAA services

•To determine the federal

reimbursement amount (FFP)

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COMPUTATION OF FEDERAL CLAIM

A. Adjusted cost pools (after revenue offset)

B. Percentage of time survey activities

C. Federal Financial Participation (FFP) Rate

D. Federal reimbursement

A x B x C = DHealthReach 2015

SUMMARY OF STEPS

1. Read MAA Invoice instructions

2. Gather the required data and

documents

3. Analyze costs and funding sources

4. Develop supporting

documentation

5. Enter data in invoice templateHealthReach 2015

DATA TO GATHER

• Claiming plan functions grid

• Time survey results

percentages

• Labor and services and

supplies costs

• Indirect/overhead expenses

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DATA TO GATHER

• Discount methodology

percentages

• Direct charged expenses

• Funding sources

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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

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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

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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

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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

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COST POOLS 3B, 4, AND 5

These totals are automatically

transferred from other worksheets in

the invoice template

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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

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Questions?

DEVELOPING SUPPORTING

DOCUMENTATION

TIME SURVEY RESULTS

• Separate time surveys by

SPMP and non-SPMP

• Total the hours by activity

code

• Analyze time surveys

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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

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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 poolsHealthReach 2015

OTHER COSTS

CP 1 - SPMP

1. Expenses that can be

attributed to SPMP staff

2. Overhead/Indirect

expenses

CP 2 - Non-SPMP

1. Expenses that can be

attributed to Non- SPMP

staff

2. Overhead/Indirect

expenses

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OTHER COSTS

Cost Pool 3

• Costs that can be attributed to non-

claimable staff

• Unallowable costs associated with

direct service

• Overhead/Indirect expenses

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OTHER COSTS

Cost Pool 5

• Expenses that can be directly

charged to MAA

• MAA specific contracted costs

• Overhead/Indirect expenses

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OTHER COSTS

Cost Pool 6

• Expenses that can be attributed to

allocated staff

• General office expenses

• Building maintenance expenses

• Utilities

• Overhead/Indirect ExpensesHealthReach 2015

OTHER COSTS

• Identify other costs and develop

backup document showing detail

and amount to be claimed

• For costs labeled, “Special,”

“Other,” “Departmental,” provide

description

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• 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

DIRECT CHARGED EXPENSES

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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.

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REVENUES WORKSHEET

•Analyze all funding sources

•Determine allocation methodology

for offset to avoid double dipping

•Determine public funds eligible to

use as CPE

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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

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WHAT NOT TO OFFSET?

•County General Funds

•Realignment Funds

•Other Local Funds (First 5)

•MAA Reimbursements

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REVENUES WORKSHEET

1) Medi-Cal Fees and Match

2) Federal Grants and Match

3) State General Funds

4) Medicare

5) Insurance

6) Fees

7) Other Revenue

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• Summarize your revenues

quarterly

• Annual revenues may be divided

equally into each of the 4

quarters

REVENUE SOURCES

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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 - AllocatedHealthReach 2015

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

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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

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THE CMAA INVOICE TEMPLATE

1. Summary page

2. TCM time survey results

3. Revenue worksheet

4. Invoice cost worksheet

5. Direct charges worksheet

6. Invoice claim calculation worksheet

7. Variance worksheetHealthReach 2015

CMAA CHECKLISTS

•Checklist For Preparing the MAA

Detail Invoice

•Checklist For Preparing the MAA

Summary Invoice

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PACKAGING YOUR INVOICE

1. Cover Letter (on LGA letterhead)

2. MAA Invoice template

3. Include checklists

• For MAA Detail Invoice

• For MAA Summary

• Other costs detail and staff classification for CP6 and other documentation when requested

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CONTACT RESOURCES

Department of Health Care Services website

www.dhcs.ca.gov/ProvGovPart/Pages/CMAA.aspx

LGA Consortium website

www.MAA-tcm.com

HealthReach Consultants

www.healthreachconsulting.com

Questions?

Thank you for attending

HealthReach’s CMAA Invoice

Training - 2015

Nancy Leidelmeijer

805-216-6585

nleidel@healthreachconsulting.com

www.healthreachconsulting.com