Medicaid Administrative Claim Consulting

Medicaid Administrative Claim Consulting Services including, but not limited to, preparing data for MAC invoice submissions; supporting the review and maintenance of the public assistance cost allocation plan; developing indirect cost rate proposals; reviewing other possibilities for eligible Medicaid matching and federal reimbursement; and training Agency staff regarding MAC processes, rules, regulations, and related cost allocation and indirect cost requirements, as necessary.
- Services shall perform the following work:
1. Prepare data for MAC invoice submission for the Agency on a quarterly basis.
2. Prepare and support quarterly updates to the Agency’s Cost Allocation Plan (CAP), including review of applicable program, staffing, organizational, and cost allocation changes. CAP updates shall include sufficient documentation to support MAC claiming, indirect cost rate development, and other federal reimbursement activities.
3. Support submission of CAP materials to HCA and assist the Agency with revisions, negotiations, responses to questions, and resolution of issues related to CAP approval or implementation.
4. Prepare the Agency’s annual Indirect Cost Rate Proposal (ICRP), including supporting schedules, documentation, and related consultation as needed.
5. Support the Agency in submitting, revising, and negotiating the annual ICRP with the applicable cognizant agency or reviewing entity, including preparation of supporting schedules, response to questions, and development of methodology explanations.
6. Assist the Agency in reviewing other possibilities for eligible Medicaid match and federal reimbursement.
7. Participate in meetings with the Agency, HCA, federal partners, cognizant agencies, and other stakeholders as requested to explain calculated rates, allocation methodologies, supporting data, invoice modifications, CAP updates, ICRP submissions, and related compliance matters.
8. Assist with modification to invoices, CAP updates, and ICRP materials as needed.
9. Prepare, maintain, and update documentation supporting MAC, CAP, and ICRP activities, including allocation methodologies, source data, assumptions, supporting schedules, reconciliations, and backup documentation necessary to support submissions, reviews, negotiations, audits, or inquiries.
10. Provide training, tools, written guidance, and knowledge transfer to Agency staff regarding MAC invoice preparation, roster development, CAP maintenance, ICRP preparation, allocation methodologies, documentation requirements, submission timelines, and applicable federal and state requirements.
11. Provide ongoing consultation and technical assistance to operationalize approved MAC, CAP, and ICRP processes, including recommendations for process improvement, internal controls, and documentation standards.
12. Provide additional consultation, guidance, training and tools when appropriate. (i.e., Suspension and debarment, Subrecipient vs contractor, and FFATA reporting.