Washington State Medicaid Administrative Match Federally Recognized Tribes. Random Moment Time Study (RMTS) and Administrative Claiming

Transcription

1 Washington State Medicaid Administrative Match Federally Recognized Tribes Random Moment Time Study (RMTS) and Administrative Claiming

2 AGENDA Welcome & Introductions RMTS Discussion Using the Web-Based System Next Steps

3 RMTS DISCUSSION

4 OBJECTIVE To capture the amount of time spent performing MAM-reimbursable activities

5 PROCESS A random sample of participants are asked to answer RMTS questions at a random moment: What were you doing? Who were you doing it with? Why were you performing this activity? Where were you? For each question, participants choose response from a list of answers: If answers do not apply, participant will provide written response

6 PROCESS HCA will code responses to an activity code and calculate RMTS percentages: Participants are not responsible for knowing activity code definitions

7 PROCESS HCA and Federally Recognized Tribes develop methodology UMMS provides consultation HCA submits methodology to CMS HCA responds to CMS questions CMS approves methodology UMMS customizes system based on approved methodology

8 RMTS DEMONSTRATION USING THE WEB-BASED SYSTEM

9 CALENDARS

10 CALENDAR SET-UP

11 CALENDAR SET-UP

12 PARTICIPANT UPLOAD

13 PARTICIPANT WELCOME

14 LOGIN SCREEN

15 USER ACCESS AGREEMENT

16 ONLINE TRAINING LINKS

17 TRAINING SUMMARY EXCEPTION REPORT

18 MOMENT BY DATE REPORT

19 AT THE MOMENT NOTIFICATION

20 ACTIVE MOMENTS

21 ANSWERING A MOMENT

22 SELECTING A PREDEFINED ANSWER

23 WRITING AN ANSWER

24 NARRATIVE BOX

25 AFTER THE MOMENT NOTIFICATION

26 MOMENT NOT COMPLETED REPORT

27 CUSTOMIZATION OF SYSTEM FFP Rate(s) Allowable Costs Federally Recognized Tribes Number of Moments & Oversample Activity Codes Grace Period Job Descriptions Online Training RMTS Questions & Answers Groups/Clusters

28 RMTS PROCESS Identify Participants Enter Calendar/Hours Calculate Results Generate Moments Monitor Compliance Notifications Complete Moments

29 RMTS PROCESS: PRIOR TO QUARTER MAM Coordinator Review System Technical Specifications with technical staff MAM Coordinator Update participant list as needed MAM Coordinator Enter/update RMTS calendar and hours MAM Coordinator Notify participants to complete online training MAM Coordinator Provide participant training as needed

30 RMTS PROCESS: PRIOR TO QUARTER HCA HCA HCA HCA Verify all data is entered by Federally Recognized Tribes Release all pending (new) User IDs Generate moments Provide coordinator training

31 RMTS PROCESS: PRIOR TO QUARTER UMMS Send s with user IDs and temporary passwords to new participants UMMS Troubleshoot any undeliverable s UMMS For initial RMTS, complete all steps including uploads, selecting moments, calendar/hours, etc.

32 RMTS PROCESS: DURING THE QUARTER MAM Coordinator Monitor participation using live reports MAM Coordinator Communicate with HCA on participant changes (change of status)

33 RMTS PROCESS: DURING THE QUARTER HCA Assign Activity Codes to moments HCA Process change of status requests HCA Monitor participation using live reports

34 RMTS PROCESS: DURING THE QUARTER UMMS UMMS UMMS Send notifications of upcoming moments Send reminders to complete moments, as necessary Provide system-related assistance, including password resets UMMS Monitor participation using live reports

35 RMTS PROCESS: AFTER THE QUARTER UMMS Calculate RMTS percentages UMMS Calculate participation percentages

36 CLAIMING PROCESS Enter/Upload Salary & Benefits Enter Supplies, Purchased Services, ICR & MER HCA reviews/approves claim System calculates claim Federally Recognized Tribe submits claim to HCA System produces A-19 and Local Match

37 CLAIMING PROCESS MAM Coordinator Extract participant list from system and create salary upload file MAM Coordinator Upload or enter quarterly salary & fringe benefits expenditures MAM Coordinator Enter quarterly supplies, purchased services, ICR & MER MAM Coordinator Certify and submit claim

38 CLAIMING PROCESS HCA Review claim HCA Submit to CMS HCA Process payment to Federally Recognized Tribes

39 CLAIMING PROCESS UMMS Calculate claim UMMS Produce A19 and CPE UMMS Support and Troubleshooting

40 NEXT STEPS