Federal Financial Participation (FFP)

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Federal Financial Participation (FFP)
New Perinatal Services Coordinator (PSC)
Orientation November 2, 2011
Jonathan Alspektor, BSBA State of California
Contract Manager
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Objectives for this Presentation

• FFP Definition and Objectives
• FFP Requirements
• FFP Reimbursement
• FFP Decision Tree
• FFP Secondary Documentation

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What is FFP?

• Federal Financial Participation (FFP) is a Title
  XIX (Medicaid) program that allows states to
  receive partial reimbursement for activities that
  meet FFP objectives.

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What is FFP?

• FFP has two programs
• 1.) Targeted Case Management TCM
• 2.) Medi-Cal Administrative Activities MAA
• MAA FFP reimburses for activities that primarily
  involve linking clients to Medi-Cal services
  and/or coverage.
• MCAH FFP is a MAA program.

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FFP Requirements

• Qualified Perinatal Services Coordinator (PSC)
  must
• Be a Skilled Professional Medical Personnel
  (SPMP) and must meet Federal SPMP requirements
  not State or County.
• Complete SPMP Questionnaire
• Complete activities that meet at least one of the
  two FFP Objectives .

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FFP Requirements

• Qualified Perinatal Services Coordinator (PSC)
  must
• Time Study
• Adhere to current MCAH Policy Procedure
  position requirements

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FFP Personnel

• There are two FFP personnel classifications
• 1.) Skilled Professional Medical Personnel (SPMP)
• Education and training at the professional level
• Nurses, physicians, Registered Dieticians, etc.
• 2.) Non-Skilled Professional Medical Personnel
  (Non-SPMP)
• All other personnel

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SPMP Requirements

• All SPMPs must complete the SPMP Questionnaire
• Determines SPMP or Non-SPMP
• Complete once and keep on file for audit purposes.

Double-click on image to show full screen example
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FFP Objectives

• 1.) To assist individuals eligible for Medi-Cal
  to enroll in the Medi-Cal program
• and/or
• 2.) To assist individuals on Medi-Cal to access
  Medi-Cal providers, care and services.

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FFP Time Study

• Staff claiming FFP reimbursement must keep record
  of 100 of their time and activities for all
  programs (including non-MCAH programs) for a
  minimum of one month each quarter.
• The start and stop time of all activities are
  required on each time study at a minimum of 15
  minute intervals.

Double-click image to show full screen example
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FFP Reimbursement

• 50/50 Non-Enhanced Matching (Non-SPMP)
• 1 spent .50 cents reimbursed
• 75/25 Enhanced Matching (SPMP)
• 1 spent .75 cents reimbursed

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FFP Reimbursement

• Medi-Cal Factor (MCF)- Medi-Cal paid births as a
  percentage of live births in each county.
• Comprehensive Perinatal Services Program (CPSP)
  is a Medi-Cal program serving only Medi-Cal
  providers and clients.
• PSCs can claim up to 95 of their matchable
  activities.

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FFP Decision Tree

• Determines if an activity can be matched
• Determines the codes than can be claimed for an
  activity

Double-click image to show full screen example
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SPMP FFP Codes
Enhanced (75/25 Matching) 2 Administrative
Medical Case Management (Short Term Only) 3
SPMP Intra/Interagency Coordination,
Collaboration and Administration 6 SPMP
Training 8 Program Planning and Policy
Development 9 Quality Management
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Non-SPMP FFP Codes

• Non-Enhanced (50/50 Matching)
• 1 Outreach
• 4 Intra/Interagency Collaboration and
  Coordination
• 5 Program Specific Administration
• 7 Non-SPMP Training

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Other FFP Codes

• 10 Non-Program Specific General Administration
• 11 Other MCAH Scope of Work Activities that
  are not matched
• 12 Paid Time Off

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Function code examples

• FUNCTION CODE 1
• Outreach
• Examples
• Informing potential client about the services
  offered by a CPSP provider
• Describing range of services, how to access them,
  and the benefits of preventative health care.

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Function code examples

• FUNCTION CODE 2 (SPMP)
• SPMP Administration Medical Case Management
• Examples
• Consulting with a Medi-Cal provider in regards to
  the clients or the infants health needs.
• Assisting Medi-Cal client in contacting their
  physician for clarification on a specific medical
  condition such as gestational diabetes and its
  effect on her pregnancy.

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Function code examples

• FUNCTION CODE 3 (SPMP)
• SPMP Intra/Interagency Coordination,
  Collaboration, Administration
• Examples
• Meeting with Dental providers to develop
  strategies to increase access to dental services
  for pregnant women.
• Community Action and Planning strategy meetings

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Function code examples

• FUNCTION CODE 4
• Non-SPMP Intra/Interagency Collaborationand
  Coordination
• Examples
• PSC provides assistance to a CPSP Provider with a
  technical question related to the program i.e.
  Billing for services to Medi-Cal.

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Function code examples

• FUNCTION CODE 5
• Program Specific Administration
• Examples
• Reviewing reports, documents, and/or legislation
  for potential impacts to the CPSP programs.
• Coordinate logistics for outreach services from
  various programs to prevent duplication of
  services and encourage optimal use of resources
  for Medi-Cal clients.

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Function code examples

• FUNCTION CODE 6 (SPMP)
• SPMP Training
• Examples
• Develop, conduct, or participate in training for
  CPSP physicians, nurse practitioners, and office
  nurses to increase access to Medi-Cal services.
• Using skilled medical expertise to deliver
  professional training to health care providers
  that will improve quality of care.

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Function code examples

• FUNCTION CODE 7
• NON-SPMP Training
• Examples
• Participate in training on data sources, data
  management and preparation for analysis to
  improve access to care for Medi-Cal clients.
• Attending an FFP training

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Function code examples

• FUNCTION CODE 8 (SPMP)
• SPMP Program Planning and Policy Development
• Examples
• Identify, recruit, and provide program support
  for new providers to expand access for CPSP
  clients.
• Assisting providers with CPSP clinical
  requirements and implementation.

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Function code examples

• FUNCTION CODE 9 (SPMP)
• Quality Management bySkilled Professional
  Medical Personnel
• Examples
• Developing training materials for CPSP providers
  for quality assurance monitoring.
• Reviewing CPSP provider arrangements to assure
  continuous provision of required consultant
  services.

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Function code examples

• FUNCTION CODE 10
• Non-Program Specific General Administration
• Examples
• Agency related activities, such as, fire drills.
• Staff attend agency meetings and non-program
  related trainings such as HIPAA, Safety Training,
  Sexual Harassment.

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Function code examples

• FUNCTION CODE 11
• Other Activities (Included in MCAH SOW)
• Examples
• Attending Child Abuse Prevention Council
  meetings.
• Smoking cessation training.

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Function code examples

• FUNCTION CODE 12
• Paid Time Off
• Examples
• Paid time off for a Holiday, sick leave,
  vacation, or jury duty

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Federal Financial Participation (FFP)Secondary
Documentation

• Purpose
• The information and data that substantiates and
  supports reimbursable activities claimed on the
  Time Study.
• Ensures Program Integrity
• Informs Auditor

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Federal Financial Participation (FFP)Secondary
Documentation

• Documentation Requirements
• Requirement of All FFP Staff
• Evidence of FFP Activities Performed
• Provides Audit Trail
• Accessible and Available
• Records Must Be Retained

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Federal Financial Participation (FFP)Secondary
Documentation

• Example SPMP Program Planning And Policy
  Development Function Code 8
• Good
• 5/21/09 from 1200-200 (when) Attended the
  South Bay Prenatal Access Task Group meeting
  (where). The membership, doctors and nurses
  (who), discussed and made plans (what) to
  increase access to prenatal care clinics (why).
• Other relevant details might include the meeting
  agenda and participant list
• Poor
• Met with the South Bay Prenatal Access Task Group
  about access to prenatal care clinics

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Federal Financial Participation (FFP)Secondary
Documentation

• Supporting Documents
• Job specifications
• Duty statements
• Organizational chart
• Scope of Work

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Federal Financial Participation (FFP)Secondary
Documentation

• Guidelines and Suggestions
• No standardized form but must provide evidence
• Notes should be detailed and specific
• Attach other types of documentation, such as,
  agendas, day planner, flyers, client notes, etc.

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Federal Financial Participation (FFP)Secondary
Documentation

• Secondary Documentation can be anything an agency
  chooses, but it should include the following
  elements
• Date
• Time Spent
• Activity
• Program

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Federal Financial Participation (FFP)Secondary
Documentation

• Secondary Documentation can be anything an agency
  chooses, but it should include the following
  elements
• Identify the client/Program/Event for which the
  activity was performed
• Function Code

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Federal Financial Participation (FFP)Secondary
Documentation

• REMEMBER
• Secondary documentation must support time study
• If not supported, FFP activities cannot be
  reimbursed

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resources

• MCAH Business Partners
• http//www.cdph.ca.gov/services/funding/mcah/Pages
  /default.aspx
• Fiscal Policies and Procedures Manual
• http//www.cdph.ca.gov/services/funding/mcah/Pages
  /FiscalPoliciesandProceduresManual.aspx

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Questions?
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