SMAA Q & A's from "Train the Trainer"
Listed are the parking lot questions and answers from the State's annual trainings beginning from Fiscal Year (FY) 2010/2011. The FY in which the answer to the question was valid is indicated in parenthesis for easy reference.
Training
Q:
If a time survey participant is new to time surveying, and is trained on the first day of the survey week, when can
they participate in the time survey process?
A: They can begin surveying immediately after the training. No surveying during the training.
(06/2011)
Q:
Can DHCS please post the Tran the Trainer notice on the MAA website to insure that all coordinators and vendors get notice. Some LECS do not notify vendors of the trainings or post the training notice on their websites. The problem will go away if the notice is posted on the MAA website.
A: Vendors are welcome to contact LEC’s and LGA’s for annual state training announcement information, DHCS will announce the training in the future.(06/2011)
Q:
Will PP with audio be available on the MAA Website?
A: Yes, a link will be posted to the webpage.
(06/2011)
Q: This training is identified as "train the trainers 2010/2011”; yet, it's not an official training since it is still in FY 09/10. Will there be an additional training in FY 10/11?
A: The SBMAA manual clearly states that all staff who time survey must participate in annual time survey training within the fiscal year being claimed. Therefore, the DHCS 2010/2011 ‘Train-the-Trainers’ session only qualifies the LEC/LGAs 2010/2011 required training. The LEC/LGAs are then responsible to ensure all their districts receive time survey training that meets DHCS guidelines and that vendors incorporate the most current DHCS training information within their trainings.
(06/2010)
Q: Can the School Site MAA Coordinator, after being trained herself, go to her District and train her staff? Or must only the LEC/LGA train all participants?
A: Once the LEC has been trained by the DHCS, they can train the LEA MAA Coordinators and the School Site Coordinators, within the fiscal year being claimed. This training qualifies the Coordinators to train their school site staff. The key is demonstrating that the LEA coordinators have been trained by the LEC/LGA coordinator through training documentation. During the 2010/2011 fiscal year some vendors have gone to a virtual training format which the Regional LEC/LGA has approved. The participant is required to complete the online training and print a certificate verifying their participation. If the LEA coordinator completes the virtual training and later trains other employees who don’t use the online training, the LEA staff training requirement is met.
(06/2010)
Q: Will there be an annual time survey training before the third quarter FY 2010/2011?
A: There will not be another 2010/2011 training by the state. Annual time survey training for those trained the preceding year must be completed before the 3rd quarter time survey week each fiscal year.
(06/2010)
Q: LEAs have contracts with the state through the LECs and LGAs. Vendors do not have contracts with the state or federal government. Why then will today’s training satisfy the state's requirements for LGAs LECs and vendors, but not for the LEA Coordinators who are logged on to this training?
A: This is a very sound point and perhaps what needs to be clarified is the LEC/LGA responsibility to ensure vendors provide training to districts that meet DHCS guidelines. The vendors do not have to satisfy a state training requirement. The state training allows all vendors to hear how the state interprets the regulations and apply that understanding in the development of their training materials. (06/2010)
Q:
I just went on the DHCS website and could not locate presentation. Can you identify where I can find it for after the session?
A: The 2010/2011 “Train-the-Coordinators” presentation can be downloaded at:
Q: Can MAA Participants be trained via webinar?
A: Yes (06/2010)
Time Survey & Invoice
Q: Totaling the number of samples from all Codes differs from past practice in applying the 80% rule. Can DHCS put something in writing to confirm the new method of determining 80% accuracy?
A: This is not a new method of determining 80% compliance. The total number of samples on the survey form must meet 80 percent compliance. Refer to slide 67.
(06/2011)
Q: Is it necessary to initial areas at the top of the forms, by name, dates, claiming unit information?
A: No
(06/2011)
Q: Time surveys with only code 15 and Code 16 time and no reimbursable time are not allowed unless consistently reporting MAA time? Please clarify “consistently”. Can they be included in the average? Please advise.
A: Per 5-15 of the SMAA Provider Manual, exceptions would be a LEC/LGA or LEA MAA staff member on paid absence or leave who typically performs MAA as demonstrated through previous time surveys and the duty statements.
(06/2011)
Q: I’m more confused. Does this mean if a participant works 40 hours, and they only record 38, we can add 2 hours of Code 1 to their time survey?
A: A participant who does not have all their normal work hours recorded may put the remaining hours in Code 1.
(06/2010)
Q:
Can you please repeat the information about rounding the percentages on the claim?
A: This often occurs when the time survey summary report percentages do not match the amounts entered in the time survey results on Tab 1 of the invoice. This is normally a rounding disparity created by the use of multiple database programs used to generate the survey results percentages. If there is a discrepancy between the required summary report and the percentages on Tab 1 of the invoice, you must increase or decrease the Code 1 (only) percentage accordingly in order for both documents to reflect the same percentages.
(06/2010)
Q:
The allowed sample does not state the "WHO" in the sample. Will you accept a sample without the "for a student"?
A: The “WHO” in the sample may occasionally be implied, such as a referral made within an IEP meeting.
(06/2010)
Q:
The samples given do not answer why. Is it ok to only answer who, what, and where?
A: Some samples describe activities performed for obvious reasons, such as Code 6 assistance activity performed because a family has no health care coverage.
(06/2010)
Q:
Do the samples have to state the services are "covered by Medi-Cal"?
A: If the service or the provider is generally recognized as being covered by Medi-Cal, the additional identification is not necessary.
(06/2010)
Q:
I noticed you don’t use the word “Medi-Cal” in all of your samples. Where do you draw the line for this in acceptable samples?
A: Code 4 samples and Code 8 samples without Medi-Cal are allowed when the description includes a referral to either a recognized Medi-Cal provider or a Medi-Cal covered service.
(06/2010)
Q: Is a lack of non-MAA activity coded in the non-MAA codes a red flag? Is it assumed that if a participant is claiming MAA, they would be performing the parallel activity as well or is time reported in any non-claimable code satisfactory?
A:
Lack of MAA activity in two parallel codes is sometimes a red flag. This may be questioned due to job classification, such as a School Secretary with Code 4 and Code 8 activity but no time reported in Code 3 and Code 7. Another example would be a survey with all paid time reported as MAA activity.
(06/2010)
Q:
Does a sample need to state "Medi-Cal eligible student"? Staff would not generally know if they were eligible or not for Medi-Cal.
A: The MAA claim is based upon the employee’s paid time and activity during that time. Samples should not include a reference to the student’s Medi-Cal eligibility.
(06/2010)
Q: Is this presentation entitled "Time Survey Form" also on the Web?
A: The 2010/2011 DHCS Time Survey form is available for download at:
Q: Can you verify who initials on strike-outs and updates on the original time survey forms? Is it true participants must initial on the time increment and sample section, and the coordinator can only initial on the header (i.e., job class, training date, etc.)?
A: The LEA MAA Coordinator can make changes on the time survey to the header, such as: Name, Job Classification, Employee Number (optional), Claiming Unit and school, normal paid work hours per week and the time survey training date. All time survey increments and samples can only be changed by the time survey participant. Also the Code and hourly totals (on the side of the form) can be changed by the LEA MAA Coordinator.
(06/2010)
Q: I have a question regarding participants that time survey and have furlough days that are not paid during the time survey week and those participants who do not have furlough days, and students may be in session?
A: The first rule is that students must be in session to time survey. Participants must time survey their paid time and only their paid time. Claiming unit members must all survey on the same five consecutive days.
(06/2010)
Q: One of the trainers stated “do your best to get a signature” referring to the time survey form. Is DHCS implying that (for any reason) obtaining a signature is negotiable?
A: Time survey forms must be completed with dated signatures before the survey results are included in an invoice. There are no exceptions. The Office of Management and /Budget (OMB) Circular A-87 signature requirement is in Attachment B-SELECTED ITEMS OF COST. Please refer to California School-Based MAA Manual 2010 pages 6-3, 6-4, 8-2, and Appendix G page 1 of the program time survey.
(06/2010)
Q: Should Time Surveys be included in the invoice when they have less than 1 hour of MAA time and do not include
Code 15?
A: Any time coded to a MAA activity in Code 4, 6, 8, 10, 12, and/or 14 is claimable. The LEC/LGA MAA Coordinator is responsible for ensuring accuracy of MAA invoices in his or her region, checking reasonableness, completeness, and submitting them to DHCS.
(06/2010)
Q: If you take a day off without pay, the time survey will not match the contracted hours per week. The time survey is short hours. Should this time go into Code 1 to balance the survey?
A: The participants must survey all of their paid time and only their paid time. If a participant takes a day of unpaid time, they must draw a line through that unpaid day on the time survey form. The normal paid hours per week (on the top of the time survey form) must balance to the total hours surveyed. If you take a day off without pay, the normal paid hours per week must be adjusted to include only your paid hours for the designated survey days.
(06/2010)
Q: Does the signature date also have to be in blue?
A: Yes
(06/2010)
Q:
Please explain 100% of worked hours or paid hours?
A: The time survey must reflect all of the time paid and activities performed by employees participating in the SMAA claiming program. In other words, the Time Survey must total 100% of the staff's work hours.
(06/2010)
Q: Please explain why our samples would not pass our LEC/LGA?
A: The LEC/LGA has the authority via contract with DHCS to oversee all aspects of MAA claiming in their region or county. If the LEC/LGA did not think the samples were acceptable they have the duty to enforce accuracy.
(06/2010)
Q:
Could you please clarify if 80% accuracy for audit compliance is for each individual survey, or the surveys used in the invoice, or for all the surveys in the claiming unit?
A: Sample activity descriptions on each time survey form included in the time survey results for the claiming unit’s invoice must maintain a minimum of 80% accuracy for the unit to meet audit compliance.
(06/2010)
Q: Do reimbursable codes (codes 4 & 8 to be exact) need to be Medi-Cal specific? The LEC in my area emphasizes this and it's been chaotic trying to revise samples that don't have M/C in them. It would be really helpful if you can clarify this. I was under the impression that samples need to be related toward an IEP or health service but do not need to be Medi-Cal specific (except for Code 6).
A: Code 4 and Code 6 samples include Medi-Cal to validate that the activities were Total Medi-Cal and claimable at the 50-percent Federal Financial Participation (FFP) rate. Code 4 samples and Code 8 samples without Medi-Cal are allowed when the description includes a referral to either a recognized Medi-Cal provider or a Medi-Cal covered service.
(06/2010)
Activity Codes - 1
2 3 4 5
6
7
8 9
10 11 12 13
14
15 16
Code 1
Q:
In regard to gearing lesson plans for an autistic child, wouldn't that be considered a Code 8 activity since the student’s lesson plans are related to the student’s health or the student's IEP?
A: The sample was written to describe evaluating curriculum and modifying the student’s lesson plan elements that are not health related.
(06/2010)
Code 2
Q:
If school personnel refer children to the school nurse for a playground injury or flu like symptoms, is it a Code 2 (free care) or a Code 4 (initial referral) activity?
A: Providing immediate attention for first aid or a health condition is code 2.
(06/2011)
Q:
Can you go into detail about "student follow-up" and how this would not be Code 8?
A: Code 2 follow-up is an extension of a medical service that evaluates the results of the medical service to ensure that either the student’s medical needs have been met or that necessary next steps are taken.
(06/2010)
Code 4
Q: If a psychologist is doing an assessment on a student and notices an eye infection and then refers that student to an eye doctor is it Code 2?
(extension of a direct service) or a Code 4 (initial referral)?
A: Code 4, as this is a different service than the psychological assessment.
(06/2011)
Q:
"Corrections" - mental health counselor was not identified as a Medi-Cal service or a Medi-Cal provider. This is being emphasized in many regions. Does this information need to be inserted?
A: School and public health counselors with appropriate credentials/licenses are listed as County Mental Health /Rehabilitation Services in the School-Based MAA Manual page 6-8 as Medi-Cal Providers Supporting Schools.
(06/2010)
Q:
Your sample only stated that Medi-Cal flyers were distributed. Must the language "discussed, explained, etc." be used in the sample, along with "handed out a Medi-Cal flyer"?
A: If the employee also explained the program, then including “discussed, etc.” would clarify the activity. Since some outreach occasions are limited to distribution, the example is acceptable if it accurately describes the activity and if the employee distributed the flyers for 8 minutes or more.
(06/2010)
Q:
Must the word "initial" be used in the sample? Code 8: Must the word "ongoing" or a similar word be used in the sample?
A: Yes, use the word "initial" when appropriate on code 4. For Code 8, yes, use ongoing, similar or like wording.
(06/2010)
Code 6
Q: How would DHCS know if question 8 on the Healthy Families application was marked and the time was not allowable?
A: As various site review protocols are developed, DHCS interview employees when reviewing time surveys from current and prior quarters.
(06/2010)
Code 7
Q:
What if they do not know where to get immunizations, and you refer them to a local Medi-Cal clinic?
A: Referrals for state education agency mandated immunizations and child health screens are not reimbursable MAA activities. Referring to a Medi-Cal clinic for the mandated school immunization is not a claimable activity.
(06/2010)
Code 8
Q:
If a college nurse is treating/seeing a student with a skin rash, and refers that student to an outside Medi-Cal clinic dermatologist is this a code 4 activity?
A: If this is a continuation of the same service this is a code 8.
(06/2011)
Q:
Please clarify that Targeted Case Managers and Case Managers not billing TCM under the LEA Billing Option can not bill TCM activity and Case Management to Code 8.
A: You can bill for TCM or MAA but not both. See slide 38.
(06/2011)
Q:
Must the word ongoing or something similar be used in each sample
A: Yes, use the word “ongoing” or something similar.
(06/2010)
Q:
Could you please describe "monitoring" as it relates to a Medi-Cal service
A: I communicated with a student’s respiratory therapist to verify that she had received all the approved treatments. Code 8 monitoring is administrative activity that ensures a child has received the prescribed medical/mental health services. Such as monitoring the adjunct medical services or consultations required for the student are provided to the direct service and that teachers and other professionals are kept apprised of student(s)’ medical interventions.
(06/2010)
Q:
Must Code 8 interactions always include a health practitioner? For example, a parent and teacher are discussing a student's Medi-Cal services. Neither is a health practitioner.
A: No, Code 8 activities do not require inclusion of a health practitioner.
(06/2010)
Q:
If participants are doing “program planning with in-house staff”, then should this code be Code 8?
A: Code 8 is used when working with in-house staff to coordinate individual students’ Medi-Cal covered services. However, Code 8 is not exclusive to “in house” providers. Often time spent with outside “community providers” to case manage services is coded here.
(06/2011)
Q:
Can monitoring the progress of Medi-Cal services with a mental health counselor outside an IEP be coded as Code 8, or must a student have an IEP first to monitor the progress of Medi-Cal services with a mental health counselor in order to be a Code 8?
A: Monitoring Medi-Cal covered services outside an IEP would be Code 8 activity.
(06/2010)
Q: A reference in Code 8 was made to a "Medi-Cal eligible” student. Is it the student or the health service that should be identified as “Medi-Cal eligible”?
A: The service should be identified as Medi-Cal covered.
(06/2010)
Q:
Do the services in codes 8 and 10 need to include a reference to Medi-Cal?
A: For Codes 8 and 10 either Medi-Cal covered or the specific health service must be included.
(06/2010)
Code 10
Q:
Must the Medi-Cal service be identified when arranging transportation?
A: When arranging transportation to a Medi-Cal covered service the service should be indicated in the sample.
(06/2010)
Code 12
Q:
I thought arranging for translation was Code 12, but if you actually provided the translation yourself, the activity then becomes what the Medi-Cal activity was: “I referred a student to a Medi-Cal covered mental health service” and not that I translated my referral to the service. In other words, the activity takes priority over the translation. What if you are doing both? Could you please clarify?
A: School employees who provide Medi-Cal translation as a third party should use Code 12. (06/2010)
Q:
If a Speech Therapist or other practitioner arranges for a third party translator to speak to the student and parent during an assessment, is this correct? The assessment would be Code 2 for the practitioner of course, but what about the time spent arranging for the translator?
A: Yes, arranging for translation services would be a MAA translation activity.
(06/2010)
Q:
Does a MAA participant have to be a title translator to claim translation time, or can translation just be included in the job duty statement?
A: MAA translation time may be claimed by a third party employee with any job classification approved for Code 12 activity.
(06/2010)
Q:
In Code 12 where translation is allowable as an "administrative activity”, is this also referring to allowable time in Code 16?
A:
All MAA activities are defined as administrative activity to differentiate them from medical services. The use of “administrative activity” is not a reference to Code 16.
(06/2010)
Q:
Is written translation of M/C material claimable
A: Yes, written translation of M/C material is claimable if it isn’t included and paid for as part of a medical service.
(06/2010)
Code 14
Q:
Must Code 14 always be interagency? Sometimes school staff develops health policies and delivery of M/C services within their district.
A: Yes. Program planning is limited to work in conjunction with other districts, COEs and public/private agencies to improve the coordination and delivery of Medi-Cal covered medical/mental health services to students and their families. It is performed only by employees whose job classifications are approved for Code 14.
(06/2011)
Q:
Can the ability to log a code 14 be part of the duty statement and not the job description of the participant?
A: Each MAA Code approved in a MAA Duty Statement should reflect duties included in the district job description/job specifications for the job classification.
(06/2011)
Q:
For code 14, do we have to identify the specific agency?
A: No. The sample must clearly describe interagency activity. In some cases, identifying the specific agency is the most effective way to do that.
(06/2011)
Q:
Top Findings: The Narrator did not mention an outside agency in the code 14 sample. The outside agency was not listed as an acceptable example. Please clarify.
A: Countywide health service agencies and health care center are intended to represent other agencies.
(06/2010)
Code 15
Q:
I have a question as to what is acceptable to write on the time survey form: “completed time survey form” or, does it need to read “completed MAA time survey form”?
A:
The addition of MAA would clarify the sample.
(06/2010)
Q: Is code 15 time allowed only on days in which claimable time has been recorded?
A: Code 15 time is recorded for the day and time the activity is performed. An employee may spend time reviewing MAA activity code descriptions and determine that their activities were not claimable.
(06/2010)
Q:
Is code 15 time allowed only on days in which claimable time has been recorded?
A: Code 15 time is recorded for the day and time the activity is performed. An employee may spend time reviewing MAA activity code descriptions and determine that their activities were not claimable.
(06/2010)
Code 16
Q:
Paid time off does include contracted paid time for lunch. Should the contract showing this be in the audit binder?
A: Yes
(06/2010)
Q: Does the participant have to include the word "paid" within the sample to claim Code 16?
A: The word “paid” is included to confirm that the time off was actually paid. Experience has shown that certificated employees may think of their non-contracted days as vacation and record the time as paid time off.
(06/2010)
Q: Does paid time off include "paid breaks"?
A: Yes, if the participant spends 8 minutes or more on a paid break.
(06/2010)
RMTS
Q: When will the RMTS PPL be posted on the website?
A: June 15, 2011
(06/2011)
Q:
What back up documentation from the individual will be required as part of the RMTS for auditing purposes?
A: Back-up documentation is not required per individual participant for RMTS purposes.
(06/2011)
Q:
Why is code 15 discounted for the RMTS but not for the one-week per quarter time survey?
A: It is a CMS requirement.
(06/2011)
Q:
Who are the staff who perform the coding?
A: In the current LAUSD approved RMTS plan, they are employees fully trained on the SMAA program and all the activity codes. See slide 75.
(06/2011)
Q:
Is there an opportunity for the person selected to review the coding and clarify if needed?
A: No
(06/2011)
SMAA Manual
Q:
When will the new SMAA manual be available online?
A: It will be posted on the DHCS Website by the end of June.
(06/2011)
Q: When will the new 2010-2011 MAA manual be available on the DHCS website?
A: The 2010/2011 SBMAA manual was posted on July 12, 2010, to the DHCS website and can be found at:
SMAA Manual Webpage.
Duty Statement
Q:
Was it mentioned that duty statements per job classification must match the allowable activities per job classification on the grid per invoice?
A: Duty statements document the approved activities for each job classification listed on the Claiming Unit Functions Grid. Each Duty Statement, in one document, must combine the full scope of work and the approved MAA activities for the job classification.
(06/2010)
Mental/Behavioral
Q:
“Behavior" under the Ed Code is under Mental Health. For school personnel, behavior is a mental health issue and adding “mental health” to the time survey sample would be stating the obvious and may be missed by participants. Is this necessary?
A: A claimable activity should include a sample that references a Medi-Cal service provider from section 6-8 and could simply state “referral for MH evaluation/services”.
(06/2010)
Q: In some cases can Mental Health be listed as Behavioral Health?
A:
If it is a mental health service, the answer is yes but it should not be referenced as behavioral.
(06/2010)
Q:
Can you please explain why behavioral health is not accepted as mental health? Our mental health programs are now referred to as “Behavioral Health programs”.
A: Behavioral health is a condition of Mental health but not a billable medical service through the LEA Medi-Cal Billing Option Program. Reference to Mental health provider without naming the condition would be more acceptable.
(06/2010)
Q: If a nurse was referring a student to a psychologist for behavioral health, then is this ok as a claimable activity?
A: A referral to a psychologist to review student needs/services would be more appropriate.
(06/2010)
Q:
Can Business Department staff preparing the documentation for the invoices each quarter claim MAA?
A: The costs of positions or portions of positions, which are included in the numerator of the Indirect Cost Rate (ICR) cannot be claimed as this would be double claiming since the ICR is applied to the total MAA cost. The function codes included in the numerator of the ICR are: Function codes: 7120, 7190, 7200-7600, 7700, 8100-8400 and 8700.
(06/2010)
Free Care
Q:
Is “free care” only related to mandated screens and immunizations? What about a teacher who refers a student with a stomachache to the school nurse?
A: The “Free Care” policy precludes Medi-Cal from paying for the costs of Medicaid-coverable services and activities that are generally available to all students without charge and for which no other sources of reimbursement are pursued. A teacher referring a student to the school nurse for a stomachache is a code 2 activity. Administering first aid, or a prescribed injection or medication, to a student is also Code 2.
(06/2010)
Immunizations
Q:
Do you know if there are immunizations that aren't state mandated for which outreach as an example might be claimable?
A: There are six vaccinations that are not required but recommended: Human Papillomavirus (HPV), Rotavirus vaccine, Pneumococcal vaccine, Hepatitis A vaccine, Tdap vaccine and Meningococcal vaccine.
(06/2010)
Q: Is a referral for H1N1 shots to a non-county health office (their pediatrician) a covered activity?
A: Any outreach or referral/coordination regarding solely H1N1 information is not a Medi-Cal covered activity. Please remember that this is a Medi-Cal program and the intent of the program is to connect students and their families with Medi-Cal covered services and the Medi-Cal application process. H1N1 guidelines: H1N1–Schools are conducting clinics providing H1N1 immunizations. This is not claimable under MAA or LEA Medi-Cal Billing Option programs. The Department of Public Health has provided funds to local health departments for H1N1 costs.
(06/2010)
Acronym
Q:
In the Code 4 sample there was an abbreviation of SLP. I thought that abbreviations were unacceptable except for M/C?
A: A few common educational acronyms are acceptable.
(06/2011)
Q:
If acronyms are used in time surveys and not spelled out on the actual time surveys, is it OK if we just include a document of acronyms and their meanings in the district’s audit binder?
A: Yes
(06/2010)
Q: Is it acceptable to use MC/HF in samples to represent Medi-Cal/Healthy Families?
A: It is acceptable to use MC for Medi-Cal and HF for Healthy Families in samples on the time survey forms.
(06/2010)
Misc/General
Q: None of the Code 4 samples include the word “Medi-Cal”. Is the inclusion of this word no longer emphasized?
A: Since the Medi-Cal service or provider is emphasized “Medi-Cal” is not required.
(06/2011)
Q: We have been told by our Vendor that the use of Healthy Families was discouraged, but I see it has been used in samples, is that acceptable?
A: The use of Healthy Families is discouraged, and Health Families is acceptable only when used with Medi-Cal.
(06/2011)
Q: Will samples that clearly refer to specific Medi-Cal covered health service be accepted during DHCS reviews even if the word Medi-Cal is not present?
A: Yes
(06/2011)
Q: If LECs make up rules mid year that contradict in very obvious ways can we appeal direct to DHCS? The LECs have too much control over what they will allow, even if it is nonsense.
A: Each LEC has certain standards that LEA’s must meet.
(06/2011)
Q: Due to confidentiality, we do not keep absence verifications of the time survey participants in the MAA Audit Binder. However, the verifications are available with our payroll unit and this is noted in the MAA Audit Binder. Is this acceptable?
A: Yes
(06/2011)
Q:
Where would we be able to get applications for the Healthy Families program? Are schools able to acquire Healthy Families applications?
A: The order form for the Medi-Cal and Healthy Families application can be downloaded at: DHCS Forms webpage, MC 370 (PDF). Medi-Cal and Healthy Families share the same application, so if an applicant does not qualify for one program, the application goes directly to the other plan for review. Both programs are administered through the Department of Health Care Services (DHCS).
(06/2010)
Q:
Medi-Cal covered services. It could be argued that your Physicals, including sports physicals, are potentially sports physical example is a reasonable sample.
A: The CHDP manual lists sports or camp physical examinations as Medically Necessary Interperiodic Health Assessments (MNIHA). Complete health assessments may be performed before the next regularly scheduled physical examination.
(06/2010)
Q: What does 50 percent FFP mean
A: States must meet certain federal requirements to participate in the Medicaid program. States must meet these requirements to receive federal funding in the form of Federal Financial Participation (FFP) for all Medicaid expenditures. The FFP for MAA is 50 percent. Please refer to page 2-1 of the SMAA Manual for additional information.
(06/2010)
Q:
What do you mean by the contract must correlate with the year?
A: The invoice requires a Contract year/quarter to be entered into row 8 of the invoice. The contract year must correlate to the year of the claiming period. Such as, the 2009/10 1st quarter invoice period should be entered into row 8 as 2009/10-1.
(06/2010)
