NYS Medicaid in Education
Medicaid Administrative Claiming (MAC) (Presentation)
Currently, school districts and counties only receive Medicaid reimbursement for direct services based on a fee for service model with an annual cost settlement process. The MAC program is a reimbursement process for claiming the costs of administrative and outreach activities that support the Medicaid program.
Medicaid Alert #13-01 
(184
KB) (posted 2/6/13)
Certified Public Expenditures (CPEs)
Federal Medicaid law and regulation authorize the use of Certified Public Expenditures (CPEs), an annual cost reconciled and settled reimbursement methodology. DOH intends to utilize CPEs in an effort to increase federal funding of the SSHSP. The CPE methodology will allow NYS to request additional federal funding for SSHSP costs that are not completely covered by current Medicaid reimbursement. DOH has contracted with Public Consulting Group, Inc. (PCG) to implement and support the additional reimbursement methodology.
The components of CPEs include a Random Moment Time Study (RMTS) and a Cost Based Settlement Process.
Random Moment Time Study (RMTS) Training (User Guide)
A user guide for RMTS coordinators and participants (direct service
providers eligible to bill Medicaid) who may be selected to receive a
random moment. This presentation provides a detailed explanation of the
Random Moment Time Study process and illustrates how to respond in the
system. This document is the training guide used in all RMTS related trainings
for the State of New York School Supportive Health Services Program.
NY SSHSP Medicaid Cost Based Settlement Process (User
Guide)
School districts and counties billing for Medicaid services
under the SSHSP will be required to participate in an annual cost reporting process.
The cost report will be used in conjunction with the RMTS in the SSHSP cost settlement
process. A cost report is a web-based software application that demonstrates
the school district’s and county's cost of providing IEP services
to Medicaid-eligible students. The school district and county business office
is responsible for completing the annual cost report.
Presentation
This presentation explains the revised process by which Medicaid
reimbursement to school districts and counties will be calculated,
effective for dates of service beginning October 1, 2011 and
going forward.
Recorded Cost Report WebEx (posted 11/6/12)
CMS Approved Direct Medical Services Materials (16 KB) (posted 9/11/12)
Additional Resources
Medicaid Alert #13-03 (56 KB) (posted 02/14/13)
SSHSP Cost Report Deadline Extended to March 15, 2013
Medicaid Alert #12-12 (46 KB) (posted 12/18/12)
SSHSP Cost Report Deadline Extended to
February 15, 2013
Medicaid Alert #12-07 (127
KB) (posted 8/1/12)
Update on Certified Public Expenditures
Medicaid
Alert #12-05 (61.70
KB) (posted 3/1/12)
(SSHSP) Questions & Answers
(5) (112.83
KB) (posted 3/16/12)
Reminder: RMTS Rosters Due September 5, 2012 (74.63 KB) (posted 8/23/12)
Public Consulting Group, Inc. Contact Information
Hotline: 866-912-2974
E-mail: NYSSHSP@pcgus.com