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Jonathan Alspektor, BSBA Mary Wieg, PHN, MBA Contract Manager Program Consultant Jan Campbell, BSN, PHN MCAH Director San Luis Obispo

Jonathan Alspektor, BSBAMary Wieg, PHN, MBA Contract ManagerProgram Consultant

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New MCAH Director Orientation May 17, 2011 Title XIX Federal Financial Participation (FFP) Time Study. Jonathan Alspektor, BSBAMary Wieg, PHN, MBA Contract ManagerProgram Consultant Jan Campbell, BSN, PHN MCAH Director San Luis Obispo. FFP Reimbursement. FFP Requirements. - PowerPoint PPT Presentation

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Page 1: Jonathan Alspektor, BSBAMary Wieg, PHN, MBA     Contract ManagerProgram Consultant

Jonathan Alspektor, BSBA Mary Wieg, PHN, MBA Contract Manager Program Consultant

Jan Campbell, BSN, PHNMCAH DirectorSan Luis Obispo

Page 2: Jonathan Alspektor, BSBAMary Wieg, PHN, MBA     Contract ManagerProgram Consultant

Understand:

Page 3: Jonathan Alspektor, BSBAMary Wieg, PHN, MBA     Contract ManagerProgram Consultant

Federal Financial Participation (FFP) is a Title XIX (Medicaid) program that allows states to receive

partial reimbursement for activities that meet FFP objectives.

Page 4: Jonathan Alspektor, BSBAMary Wieg, PHN, MBA     Contract ManagerProgram Consultant

FFP has two programs:1.) Targeted Case Management – TCM2.) Medi-Cal Administrative Activities – MAA

MAA FFP reimburses for activities that primarily involve linking clients to Medi-Cal services and/or coverage. MCAH-FFP is a MAA program

MCAH FFP is a MAA program.

Page 5: Jonathan Alspektor, BSBAMary Wieg, PHN, MBA     Contract ManagerProgram Consultant

To assist individuals eligible for Medi-Cal to enroll in the Medi-Cal program and/or

To assist individuals on Medi-Cal to access Medi-Cal providers, care and services.

Page 6: Jonathan Alspektor, BSBAMary Wieg, PHN, MBA     Contract ManagerProgram Consultant

The MCAH program and staff must meet all FFP requirements to be reimbursed with Title XIX funds.

The local program must use qualifying non-federal funds (i.e. local county/city/state funds) to draw down Title XIX matching/reimbursement.

Only activities that meet the FFP Objectives may be reimbursed.

Page 7: Jonathan Alspektor, BSBAMary Wieg, PHN, MBA     Contract ManagerProgram Consultant

75/25 Enhanced Matching (SPMP)

$1 spent = .75 cents reimbursed

50/50 Non-Enhanced Matching (Non-SPMP)

$1 spent = .50 cents reimbursed

Page 8: Jonathan Alspektor, BSBAMary Wieg, PHN, MBA     Contract ManagerProgram Consultant

There are two FFP personnel classifications:

1.) Skilled Professional Medical Personnel (SPMP)

Education and training at the professional level (SPMP Questionnaire)

2.) Non-Skilled Professional Medical Personnel (Non-SPMP)

All other personnel

Page 9: Jonathan Alspektor, BSBAMary Wieg, PHN, MBA     Contract ManagerProgram Consultant

Staff must track 100% of their time for activities for all programs worked for a minimum of one month each quarter. (This includes non-MCAH programs).

The “start and stop” time of all activities are required on all time studies and secondary documentation.

Page 10: Jonathan Alspektor, BSBAMary Wieg, PHN, MBA     Contract ManagerProgram Consultant

SPMP Questionnaire:Assure that all SPMPs have completed the document

Keep all SPMP Questionnaires on file

FFP Time Studies:Provide & oversee FFP training for your MCAH staff

Review all staff FFP Time Studies & secondary documentation for completeness and accuracy

Page 11: Jonathan Alspektor, BSBAMary Wieg, PHN, MBA     Contract ManagerProgram Consultant

1. Is this activity in the MCAH, BIH, or AFLP Scope of Work?

Yes, continue

No, code to Other Programs

Page 12: Jonathan Alspektor, BSBAMary Wieg, PHN, MBA     Contract ManagerProgram Consultant

2. Does this activity meet the objectives in the FFP Guidelines?

Yes, continue

No, code to Code 11

Page 13: Jonathan Alspektor, BSBAMary Wieg, PHN, MBA     Contract ManagerProgram Consultant

3. Does this activity require the skill, knowledge, and expertise of an SPMP?

Yes, code to 2,3,6,8, or 9

No, code to 1,4,5, or 7

Page 14: Jonathan Alspektor, BSBAMary Wieg, PHN, MBA     Contract ManagerProgram Consultant

2: Administrative Medical Case Management

(Short Term Only)

3: SPMP Intra/Interagency Coordination, Collaboration and Administration

6: SPMP Training

8: Program Planning and Policy Development

9: Quality Management

Page 15: Jonathan Alspektor, BSBAMary Wieg, PHN, MBA     Contract ManagerProgram Consultant

1: Outreach

4: Intra/Interagency Collaboration and Coordination

5: Program Specific Administration

7: Non-SPMP Training

Page 16: Jonathan Alspektor, BSBAMary Wieg, PHN, MBA     Contract ManagerProgram Consultant

Code 11 is Other MCAH Scope of Work Activities that are not matched

Codes 10 and 12 are allocated rates:

10: Non-Program Specific General Administration (such as agency-required meeting, training, or

staff development).

12 : Paid Time Off

Page 17: Jonathan Alspektor, BSBAMary Wieg, PHN, MBA     Contract ManagerProgram Consultant

Must maintain supplemental (secondary) documentation to support information recorded on the Time Study.

Examples:

Daily logs, appointment books, calendars, meeting agendas, minutes

Page 18: Jonathan Alspektor, BSBAMary Wieg, PHN, MBA     Contract ManagerProgram Consultant

Documentation must be explicit enough to support function code used

Example: Teen Pregnancy and Parenting collaborative

meeting, discussed poor access to prenatal care for teen moms in north county.