SOESD / Special Education / Medicaid Billing / What is MAC?
What is Medicaid Administrative Claiming?
The basic idea of the program is that district personnel — in the course of their work as educators — sometimes provide services that are reimbursable under state Medicaid guidelines. Medicaid Administrative Claiming provides the mechanism to collect those reimbursements.
MAC program participants include teachers, administrators, and specialists. Other staff who can participate in the program include secretaries, classroom assistants, and other school-based personnel. The primary requirement of staff qualified to participate in MAC surveys is that they perform administrative or educational services for students. Personnel working in custodial, maintenance, warehousing, transportation, and food service jobs are excluded from participating because they do not routinely perform Medicaid-reimbursable types of activities.
Just a few examples of MAC-reimbursable staff activities include:
- Talking with students or family about Medicaid benefits
- Referring students for necessary medical health, mental health, or substance abuse services covered by Medicaid
- Coordinating Medicaid/OHP-related transportation of students
- Arranging for a translator assist students and family understand Medicaid/OHP services
- Developing strategies to assess or increase the capacity of school medical/mental health programs
Participants complete an online form once per quarter. The form takes 15-20 minutes to complete. Survey participants mark how they spent their workday on a specific survey day. Completing the surveys and attending a brief training session once per year are all that is required of participants.
From the staff person's perspective, the MAC program is easy and brief. In return for completing this simple survey, school districts are reimbursed by DHS for claimable activities. These reimbursements can be significant, and provide compensation from time spent by educators and administrators for Medicaid-related work already being performed.