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

New MCAH Director Orientation May 17, 2011 Title XIX Federal Financial Participation (FFP) Time Study. Jonathan Alspektor, BSBA Mary Wieg, PHN, MBA Contract Manager Program Consultant Jan Campbell, BSN, PHN MCAH Director San Luis Obispo. FFP Reimbursement. FFP Requirements.

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

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  1. New MCAH Director Orientation May 17, 2011Title XIXFederal Financial Participation (FFP)Time Study Jonathan Alspektor, BSBA Mary Wieg, PHN, MBA Contract Manager Program Consultant Jan Campbell, BSN, PHN MCAH Director San Luis Obispo

  2. FFP Reimbursement FFP Requirements FFP Definition and Objectives FFP Decision Tree FFP Secondary Documentation Objectives for this Presentation Understand:

  3. What is FFP? Federal Financial Participation (FFP) is a Title XIX (Medicaid) program that allows states to receive partial reimbursement for activities that meet FFP objectives.

  4. What is FFP? FFP has two programs: 1.) Targeted Case Management – TCM 2.) 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.

  5. FFP Objectives • 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.

  6. FFP Requirements • 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.

  7. FFP Reimbursement • 75/25 Enhanced Matching (SPMP) $1 spent = .75 cents reimbursed • 50/50 Non-Enhanced Matching (Non-SPMP) $1 spent = .50 cents reimbursed

  8. FFP Personnel 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

  9. FFP Time Study • 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.

  10. MCAHDirector’sRole 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

  11. FFP Decision Tree Is this activity in the MCAH, BIH, or AFLP Scope of Work? Yes, continue No, code to Other Programs

  12. FFP Decision Tree 2. Does this activity meet the objectives in the FFP Guidelines? Yes, continue No, code to Code 11

  13. FFP Decision Tree 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

  14. SPMP FFP Codes 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

  15. Non-SPMP FFP Codes 1: Outreach 4: Intra/Interagency Collaboration and Coordination 5: Program Specific Administration 7: Non-SPMP Training

  16. Other FFP Codes • 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

  17. SecondaryDocumentation • Must maintain supplemental (secondary) documentation to support information recorded on the Time Study. Examples: Daily logs, appointment books, calendars, meeting agendas, minutes

  18. SecondaryDocumentation • 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.

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