Enhancing Federal Financing and Medicaid Administrative Claiming
HCBS Strategies has extensive knowledge of federal regulation and guidance about how to obtain and maximize federal funding. We are national leaders in expanding the role of Medicaid Administrative Claiming (MAC) for ADRCs and DDRCs.
Medicaid Administrative Claiming: HCBS Strategies staff proposed the use of MAC for ADRC and NWD activities to CMS as part of the original negotiations for the ADRC pilot grants in 2003. We supported the Maryland Department of Aging (MDoA) effort which obtained approval for drawing down MAC federal financial participation (FFP) for activities that helped people who were at risk of spending down to Medicaid remain in the community. We drafted the original text and tools that are currently on ACL’s website that provide guidance on sustaining a NWD network (Sustaining A NWD System (acl.gov)).
We have assisted Alaska, Maryland, Nebraska, Hawaii, and Minnesota in developing the infrastructure for MAC and have been operating the MAC infrastructure for Nebraska since 2020. With our support, Nebraska has led the nation by expanding MAC to NWD partner agencies, such as the Brain Injury Alliance, 211, the University Center on Excellence in Developmental Disabilities, Easterseals, and the Center for Independent Living.
HCBS Strategies designs thoughtful systems that balance the goals of maximizing the amount of FFP, minimizing burden of program staff, and creating an adequate record that can survive an audit.
When working with states to explore and develop MAC, we encourage them to consider how the infrastructure, notably the random moment time study (RMTS) can help support goals beyond financing. These data can shed light on the performance of programs and staff that were previously unavailable. Because they are tied to funding, they can also be used to reshape systems to reflect programmatic goals, such as evolving from providing simply information and referral to more robust options counseling.
