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SMAA Program Update #18 October 24, 2014

Invoice Extension for Fiscal Year (FY) 2012/13 Q4 Invoice Submissions
The Department of Health Care Services (DHCS) will extend the due date for submission of FY 2012/13 Q4 invoices from October 31, 2014 to December 31, 2014. Please ensure all FY 2012/13 Q4 invoices are received by DHCS no later than December 31, 2014.
Corrections to SMAA Claims for Fiscal Year (FY) 2012/13
The new Random Moment Time Study (RMTS) methodology incorporates some of the same variables for School-Based Medi-Cal Administrative Activities (SMAA) claims as the Reasonableness Test Criteria (RTC). These include a similar prohibition against the use of certain job classifications, and the 15% limit on any vendor fees being claimed. Although there are no benchmark limits on time spent performing specific activity codes, all time claimed for activity codes must meet the same standards of “reasonable and efficient to implement the state Medicaid plan” found in 42 Code of Federal Regulations (CFR) 433.15(b)(7) and Office of Management and Budget (OMB)
Circular A-87.
The RTC was designed to ensure SMAA claims met the “reasonable and efficient” standards and these standards will be used to review all current and future SMAA claims.
Revising claims to remove components of the RTC in favor of previously approved standards may produce an unintended fiscal impact on SMAA claims once the backcasting methodology, which will be based on RMTS data, is applied to those claims.
Claims submitted for FY 2012/13 Q1 have been assigned as placeholders and there is no longer an opportunity to revise these claims. Claims submitted for FY 2012/13 Q2 will be assigned as placeholders as of November 30, 2014, therefore any 12/13 Q2 corrections must be received by DHCS no later than Friday, November 14, 2014. Corrections for FY 2012/13 Quarter 3 and Quarter 4 must be received by DHCS no later than December 31, 2014. There will be no additional extensions to submit corrections to 2012/13 Quarters 2, 3, & 4 invoices. Corrections received after the dates specified will not be processed. 
Last modified on: 7/3/2015 5:58 PM