Texas Administrative Code

Texas Administrative Code

TITLE 1	ADMINISTRATION
PART 15	TEXAS HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 355	REIMBURSEMENT RATES
SUBCHAPTER J	PURCHASED HEALTH SERVICES
DIVISION 5	GENERAL ADMINISTRATION
RULE §355.8095	Medicaid Administrative Claiming Program

(ii) equipment and other allowable costs; and

(iii) expenses for administrative staff and administrative support staff excluded from the RMTS.

(3) HHSC reserves the right to retain five percent of the federal share of actual and reasonable costs for HHSC's own administrative costs.

(g) Claim submission.

(1) To claim reimbursement for eligible activities, eligible providers must:

(A) have an active written provider agreement with HHSC executed on or before the first day of the quarter in which reimbursement is being claimed;

(B) have participated in the HHSC-administered RMTS;

(C) have a MAC financial contact who is an entity employee and who has received credit for the MAC training for the FFY in which the governmental entity wishes to submit a claim;

(D) submit a certified PL for the quarter in which reimbursement is being claimed;

(E) submit a MAC Financial Claim; and

(F) submit a certified QSI.

(2) The MAC Financial Claim and other required documents are submitted to HHSC through STAIRS.

(h) Program specific requirements for school districts. Participating school districts must:

(1) have an approved MAC Program Operating Plan on file with the HHSC Provider Finance Department; and

(2) when contracting with a vendor for which the school district will be held accountable, incorporate the authorization to enter and certify the school district's quarterly financial information into the contract and provide the contract upon HHSC request.

Source Note: The provisions of this §355.8095 adopted to be effective July 1, 2018, 43 TexReg 4169; amended to be effective April 3, 2022, 47 TexReg 1617