CMAA: Direct Charge Expenses Non-Offset Revenues We are here to discuss two essential concepts to MAA invoicing: direct charge of expenses and non-offset revenues. These are not always complicated but are certainly not the easiest part of MAA invoicing. By the end of this presentation we hope you have a greater understanding of each and some real examples.

CMAA: Direct Charge Types of expenses can include: Salary and Benefits Subcontractor Non-labor costs of services and supplies Costs of staff who time survey are not direct charge

When to direct charge staff? Requirements: Staff costs must be 100% attributable to a single Medi-Cal eligible activity Staff whose costs are direct charged must still attend an annual time survey training Staff must perform reimbursable activities 100% of the time or in distinct and documented blocks of time Staff time must be documented/logged Staff must complete “Staff Certification of Direct Charge Time” each quarter

Direct Charge Common Codes Common MAA activities for direct charge include: Code 8 - Facilitating Medi-Cal Application Code 10 - Arranging and/or Providing Non-Emergency, Non-Medical Transportation to a Medi-Cal Covered Service Code 19 - MAA/TCM Coordination and Claims Administration

Direct Charge Log Identifying staff information Date activity was performed Amount of time spent Total hours paid for day, month, or quarter Activity description

Direct Charge of Contractor Expenses Contract can be direct charged if it: Describes the claimable activities to be performed Specifies the dollar amount for each claimable activity Contingency fees cannot be direct charged

Direct Charge Non-Labor Costs Normal day-to-day operating expenses necessary to run the claiming unit Overhead costs not included in indirect rate Identify these costs and develop backup documentation showing detail and amount to be claimed

Direct Charge Non-Labor Costs Non-salary and/or overhead costs associated with MAA specific reimbursable activities (‘non-salary costs’): Travel Training Printing Computer, or other equipment costs Supporting documentation to substantiate any non-salary and/or overhead direct charges Should test in your invoice whether it is more advantageous to direct charge these costs or put them in Cost Pool 6.

Direct Charge Non-Labor Costs Transportation Costs for Medi-Cal enrolled individuals to a Medi-Cal non-emergency covered service Need to track: Client name Client Medi-Cal ID Date of service Type of Medi-Cal covered service/provider Mileage, van operating costs, insurance, driver, etc. Bus tokens, taxi vouchers, etc.

Direct Charging Other Details Staff or contractor must be listed on the CUFG Staff must be trained annually Staff must sign a Duty Statement Corresponding Activity Sheet must reflect if staff or contractors are direct charging rather than time surveying Program Planning & Policy Development can be direct charged when performed full time by an employee whose tasks officially involve program planning and policy development LGAs may also utilize the staff classification and payroll coding documents to verify the reimbursable costs for staff that perform Medi-Cal eligible services and/or activities 100 percent of the time

Cost Pool 4 vs. Cost Pool 5 Cost Pool 4: Cost Pool 5: Expenses that can be directly charged to CMAA at enhanced rate Cost Pool 5: Non-SPMP expenses that can be directly charged to CMAA CMAA specific contracted costs

Staff Certification of Direct Charge Time 2016 LGA Annual Conference

Sample Direct Charge Log LGA: Claiming Unit: Code Name: (Full-time Employee) July Note: Total Paid Hours should match time card. Date MAA Activity Description TOTAL PAID HOURS MAA Coord/Claims Admin Direct Charge General Admin. Paid Time Off Other Programs 7/1 Reviewed time surveys. 8.00 2.00 1.00   5 7/2 Attended MAA invoice training. 5.00 2 7/3 Worked on MAA invoices. 3.00 0.50 4.00 0.5 7/4

Direct Charge on CUFG NUMBER OF STAFF   Name of LGA Submittal Date Name of Claiming Unit Number of Staff Address Contact Person Phone Number Description of Claiming Unit Functions NUMBER OF STAFF MEDI-CAL ADMINISTRATIVE ACTIVITY CODE (ENTER NUMBER OF STAFF UNDER EACH ACTIVITY) STAFF JOB CLASSIFICATIONS SPMP NON- SPMP DIRECT CHARGE 4 6 8 10 12 13 15 16 17 18 19 20 MAA Coordinator 1 Subcontract – MAA Time Survey Software X

Direct Charge or Time Survey? Only document time spent on reimbursable activity Great for individuals who perform an activity in a block of time Good option for some contractors, when contract clearly describes activity and cost for that activity Time Survey Does not require a log of activities Allows for multiple codes to be claimed during the same encounter

CMAA: Non-Offset Revenues Many revenues offset expenses. Failing to appropriately identify non-offset revenues can have a major impact on an invoice. Before we look at revenues that are not off-set, we must first review at least briefly which revenues must be off-set.

REVENUES WORKSHEET Identify all revenues within the budget unit Sort between Non-Offset and Cost Pools 1 – 6 Revenues are used to determine the net cost of MAA eligible activities for federal reimbursement Some revenues can be entirely assigned to NON OFFSET or only 1 OFFSET Cost Pool. Other revenues that require partial offsetting may need to be split between the various cost pools depending on how the cost was charged in the Other Costs Worksheet of the invoice.

OFF-SETTING REVENUES Revenues that must be Off-Set: Federal funds MOE (Maintenance of Effort) Local match for federal funds State match for federal funds (including Medi-Cal fee-for-service revenue) State “carve out” programs like CCS, CHDP Payments collected from non-governmental sources for the delivery of direct client services Offset funds are required to be reported on the MAA invoice to ensure that you are not double claiming federal dollars for the same expenses to MAA and other federal grants (ex. MCAH or immunization education). Therefore, offset funds do not count towards meeting your CPE requirement. Be very careful to only offset revenues in CP 1, 2, and 6 when necessary to be in compliance as this directly reduces reimbursement on the MAA invoice.

NON-OFFSET REVENUES County General Funds Realignment Funds (MVLF and Sales Tax) The exception: Required match for programs such as CCS and CHDP Other Local Public Entity (LPE) Funds (First 5) MHSA MAA Reimbursements Potentially other revenues that not required to offset expenses Realignment used in excess of a required match can be assigned to non-offset. Other non-offset revenues: State Tobacco funds and AIDS Drug Assistance Program (ADAP) funds.

CPE Compliance Claiming Units must have enough non-offset funds to equal or exceed the amount of reimbursement being claimed for the MAA Program. For example, if your invoice total is $150,000, you must have at least $150,000 for the quarter in non-offset funds. If there are insufficient non-offset funds to match claimed expenses, this correctly reduces the amount that can be claimed. Invoice – Claim Calculation Tab

Non-Offset Revenues Tips Things to consider: Failure to identify non-offset revenues will very likely reduce the total invoice amount! Identifying revenue incorrectly as non-offset will very likely result in an audit exception! Be sure of the classification of revenues or seek assistance.

QUESTIONS & DISCUSSION Open to floor